Comprehensive Evaluation of Functional Outcomes following Total Knee Arthroplasty using International Classification of Function, Disability and Health (ICF) Model: A Longitudinal Cross Sectional study

BACKGROUND: Osteoarthritis is a degenerative change commonly occurs in weightbearing joints in the hip and knee. Pain and joint stiffness is the common symptoms that gradually leads to muscle weakness and deformity which affects the quality of life. Prevalence of OA knee is increasing due to aging and lifestyle. International classification of function and disability (ICF) is a framework model adapted by world health organization and measures health and disability at both individual and population at large. Implications of ICF give clinicians and researchers a core idea even in the areas of functioning. The ICF model evaluates the individual’s ability to participate in the society and the environmental and personal factors that might be a barrier to their participation. Total knee arthroplasty (TKA) is a surgical procedure where the articular surface of the femoral condyle and tibial plateau are replaced with the metal implant. AIM OF THE STUDY: The aim of the study is to comprehensively evaluate the functional outcomes following total knee arthroplasty using ICF model. OBJECTIVES: To compare the functional outcomes in impairment, activity limitation, participation restriction domains in ICF models following total knee arthroplasty. METHODS: 10 subjects who were planned to be operated for total knee arthroplasty after having met the inclusion criteria were included in the study with a prior consent form. Using ICF model, evaluation of functional outcomes was measured at two different points, at preoperative and followed up at postoperatively at 3 months. Study was approved by an institutional review board, Christian medical college Vellore. RESULTS: At 3 months postoperative there was a significant change in postoperative outcomes on knee society scores (KSS), muscle power of right hip abductor, WOMAC & LEFS scales, and on two subscales of LLFDI (function component & limitation subscale of disability component). However, there was no significant change in range of motion, muscle power of quadriceps and left hip abductor, handgrip strength, performance-based measures, and a subscale of LLFDI (frequency subscale of disability component). CONCLUSION: The study concluded with a need of extensive research using ICF model to provide holistic view of the patient’s conditions and plan rehabilitation measures accordingly