According to a literature review in the July issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), patients' activity level is a strong predictor for how well they will do with certain treatments and how well they recover from injuries after treatment. Patients are encouraged to ask their orthopaedic surgeon if activity level is an important factor in their treatment decision. For example, more active patients are at a higher risk of re-injury after an anterior cruciate ligament (ACL) reconstruction, and activity level should be considered when deciding which graft to use in the ACL repair.
Easily administered, standardized scales for the shoulder, hip, knee and ankle are commonly used in orthopaedics to quantify a patient's activity level. But, the measures of how often, rather than how well, a task is performed do not account for symptoms, functional disabilities, age, weight, overall health and other factors which also may impact prognostic and outcome variables.
"In orthopaedics, we want to restore function to take away pain and to help patients return to activity," said orthopaedic surgeon and lead study author Robert H. Brophy, MD. "We're still learning about how to best use, quantify and measure activity levels to optimize prognostics and outcomes."
Other literature review highlights:
"There's not just one activity level variable" in these measurements, said Dr. Brophy. "It depends on the population, the injury you're studying, etc. We're making progress, and the progress varies depending on what you're looking at."
July 2014 Full JAAOS Table of Contents
Orthopaedic Advances: Motorized Intramedullary Nail for Treatment of Limb Length Discrepancy and Deformity
Complications of Shoulder Arthroscopy
Surgical Treatment for Ossification of the Posterior Longitudinal Ligament in the Cervical Spine
The Role of Activity Level in Orthopaedics: An Important Prognostic and Outcome Variable
Contemporary Management of Adult Diaphyseal Both-bone Forearm Fractures
The Integration of Radiosurgery for the Treatment of Patients With Metastatic Spine Diseases
Osteonecrosis of the Femoral Head: Evaluation and Treatment
On the Horizon From the ORS: Mechanical Loading: Potential Preventive and Therapeutic Strategy for Osteoarthritis
On the Horizon From the ORS: Recent Progress in Osteoarthritis Research
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From Washington University, Chesterfield, MO (Robert H. Brophy, MD; Kenneth Lin; and Matthew V. Smith, MD).
Dr. Brophy or an immediate family member serves as a paid consultant to or is an employee of ISTO Technologies and Smith & Nephew; has stock or stock options held in Ostesys; and serves as a board member, owner, officer, or committee member of the American Orthopaedic Society for Sports Medicine. Mr. Lin or an immediate family member serves as a paid consultant to or is an employee of Fibrogen; has stock or stock options held in Fibrogen; and has received nonincome support (such as equipment or services), commercially derived honoraria, or other non–research-related funding (such as paid travel) from Fibrogen. Dr. Smith or an immediate family member serves as a paid consultant to or is an employee of ISTO Technologies.
J Am Acad Orthop Surg 2014; 22: 430-436 http://dx.doi.org/10.5435/JAAOS-22-07-430
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