Correction to:Being active with a total hip or knee prosthesis: a systematic review into physical activity and sports recommendations and interventions to improve physical activity behavior

OBJECTIVES: Regular physical activity (PA) is considered important after total hip and knee arthroplasty (THA/TKA). Objective was to systematically assess literature on recommendations given by healthcare professionals to persons after THA and TKA and to provide an overview of existing interventions to stimulate PA and sports participation.METHODS: A systematic review with a narrative synthesis including articles published between January 1995 and January 2021 reporting on recommendations and interventions. The PubMed, Embase, CINAHL and PsycInfo databases were systematically searched for original articles reporting on physical activity and sports recommendations given by healthcare professionals to persons after THA and TKA, and articles reporting on interventions/programs to stimulate a physically active lifestyle after rehabilitation or explicitly defined as part of the rehabilitation. Methodological quality was assessed with the Mixed Methods Appraisal Tool (MMAT). The review was registered in Prospero (PROSPERO:CRD42020178556).RESULTS: Twenty-one articles reported on recommendations. Low-impact activities were allowed. Contact sports, most ball sports, and martial arts were not recommended. One study informed on whether health-enhancing PA recommendations were used to stimulate persons to become physically active. No studies included recommendations on sedentary behavior. Eleven studies reported on interventions. Interventions used guidance from a coach/physiotherapist; feedback on PA behavior from technology; and face-to-face, education, goal-setting, financial incentives and coaching/financial incentives combined, of which feedback and education seem to be most effective. For methodological quality, 18 out of 21 (86%) articles about recommendations and 7 out of 11 (64%) articles about interventions scored yes on more than half of the MMAT questions (0-5 score).CONCLUSION: There is general agreement on what kind of sports activities can be recommended by healthcare professionals like orthopedic surgeons and physiotherapists. No attention is given to amount of PA. The same is true for limiting sedentary behavior. The number of interventions is limited and diverse, so no conclusions can be drawn. Interventions including provision of feedback about PA, seem to be effective and feasible.</p

Amount and type of physical activity and sports from one year forward after hip or knee arthroplasty-A systematic review:A systematic review

IntroductionAfter rehabilitation following total hip or knee arthroplasty (THA/TKA), patients are advised to participate in physical activity (PA) and sports. However, profound insight into whether people adopt a physically active lifestyle is lacking. Aim is to gain insight into the performed amount and type of PA (including sports) and time spent sedentarily by persons after THA/TKA.MethodsA systematic review (PROSPERO: CRD42020178556). Pubmed, Cinahl, EMBASE and PsycInfo were systematically searched for articles reporting on amount of PA, and on the kind of activities performed between January 1995-January 2021. Quality of the articles was assessed with the adapted tool from Borghouts et al.ResultsThe search retrieved 5029 articles, leading to inclusion of 125 articles reporting data of 123 groups; 53 articles reported on subjects post-THA, 16 on post-hip-resurfacing arthroplasty, 40 on post-TKA, 15 on post-unicompartimental knee arthroplasty and 12 on a mix of arthroplasty types. With respect to quality assessment, 14 articles (11%) met three or fewer criteria, 29 (24%) met four, 32 (26%) met five, 42 (34%) met six, and 6 (5%) met seven out of the eight criteria. PA levels were comparable for THA and TKA, showing a low to moderately active population. Time spent was mostly of low intensity. Roughly 50% of -subjects met health-enhancing PA guidelines. They spent the largest part of their day sedentarily. Sports participation was relatively high (rates above 70%). Most participation was in low-impact sports at a recreational level. Roughly speaking, participants were engaged in sports 3 hours/week, consisting of about three 1-hour sessions.ConclusionActivity levels seem to be low; less than half of them seemed to perform the advised amount of PA following health-enhancing guidelines Sports participation levels were high. However, many articles were unclear about the definition of sports participation, which could have led to overestimation.</p

Prevalence of Jumper's Knee Among Nonelite Athletes From Different Sports A Cross-Sectional Survey

Background: The prevalence of jumper's knee among nonelite athletes from different sports is unknown.Purpose: This study was undertaken to determine the prevalence of jumper's knee in nonelite athletes from different sports and to determine potential risk factors for jumper's knee.Design: Cohort study (prevalence); Level of evidence, 2.Methods: The authors interviewed 891 male and female nonelite athletes from 7 popular sports in The Netherlands: basketball, volleyball, handball, korfball, soccer, field hockey, and track and field. Using a specially developed questionnaire, information was obtained about individual characteristics (age, height, and weight), training background, previous and actual knee problems, and the VISA-P (Victorian Institute of Sport Assessment-Patella) score.Results: The overall prevalence of current jumper's knee was 8.5% (78 of 891 athletes), showing a significant difference between sports with different loading characteristics. Prevalence was highest among volleyball players (14.4%) and lowest among soccer players (2.5%); it was significantly higher among male athletes (51 of 502 [10.2%]) than female athletes (25 of 389 [6.4%]) (chi 2 = 3.91, P = .048). The mean duration of symptoms was 18.9 months (standard deviation [SD], 21.6; median value, 12.0; range, 2.0-59.8). The mean VISA-P score of the athletes with jumper's knee was 71.4 (SD, 13.8). Athletes with jumper's knee were significantly younger, taller, and heavier than those without jumper's knee.Conclusion: Prevalence of jumper's knee is high among nonelite athletes and varies between 14.4% and 2.5% for different sports. Jumper's knee is almost twice as common among male nonelite athletes compared with female athletes. Different sport-specific loading characteristics of the knee extensor apparatus, a younger age, a taller body stature, and higher body weight seem to be risk factors associated with patellar tendinopathy.</p

Intra- and inter-operator reliability of measuring compressive stiffness of the patellar tendon in volleyball players using a handheld digital palpation device

This observational study aimed to evaluate the intra- and inter-operator reliability of a digital palpation device in measuring compressive stiffness of the patellar tendon at different knee angles in talent and elite volleyball players. Second aim was to examine differences in reliability when measuring at different knee angles, between dominant and non-dominant knees, between sexes, and with age. Two operators measured stiffness at the midpoint of the patellar tendon in 45 Dutch volleyball players at 0°, 45° and 90° knee flexion, on both the dominant and non-dominant side. We found excellent intra-operator reliability (ICC&gt;0.979). For inter-operator reliability, significant differences were found in stiffness measured between operators (p&lt;0.007). The coefficient of variance significantly decreased with increasing knee flexion (2.27% at 0°, 1.65% at 45° and 1.20% at 90°, p&lt;0.001). In conclusion, the device appeared to be reliable when measuring compressive stiffness of the patellar tendon in elite volleyball players, especially at 90° knee flexion. Inter-operator reliability appeared to be questionable. More standardized positioning and measurement protocols seem necessary.</p

Habitual Physical Activity After Total Knee Replacement:analysis in 830 patients and comparison with a sex-and age-matched normative population (vol 92, pg 1109, 2012)

Background. Previous studies on physical activity after total knee arthroplasty (TKA) concentrated mainly on a return to sports activities. Objective. The objectives of this study were to determine the habitual physical activity behavior of people who had undergone TKA (TKA group) 1 to 5 years after surgery and to examine to what extent they adhered to international guidelines for health-enhancing physical activity. Additional aims were to compare younger (= 65 years old) people as well as men and women in the TKA group and to compare the results for the TKA group with those for a sex- and age-matched normative population (normative group). Design. This investigation was a cohort study. Methods. All people who had a primary TKA at 1 of 2 participating hospitals between 2002 and 2006 were sent the Short Questionnaire to Assess Health-Enhancing Physical Activity at least 1 year after surgery. Results. The TKA group spent, on average, 1,347 minutes per week on physical activity, most of which was light-intensity activity (780 minutes per week). Participants younger than 65 years of age spent significantly more time on physical activity than participants 65 years of age or older. There was no significant difference between male and female participants. Compared with the sex- and age-matched normative group, the TKA group spent significantly less time on the total amount of physical activity per week and met the guidelines for health-enhancing physical activity less often (55% versus 64%). Limitations. A self-administered questionnaire was used to assess habitual physical activity, and presurgery data on physical activity were not available. Conclusions. Almost half of the TKA group did not meet the health-enhancing physical activity guidelines, and the TKA group was not as physically active as the normative group. People who have undergone TKA should be encouraged to be more physically active

The Achilles tendon Total Rupture Score is a responsive primary outcome measure:an evaluation of the Dutch version including minimally important change

PURPOSE: Aim of this study was to evaluate the responsiveness of the Dutch version of the Achilles tendon Total Rupture Score (ATRS-NL). METHODS: Patients (N = 47) completed the ATRS-NL at 3 and 6 months after Achilles tendon rupture (ATR). Additionally, they filled out the Euroqol-5D-5L (EQ-5D-5L) and Global Rating of Change Score (GRoC). Effect sizes (ES) and standardized response means (SRM) were calculated. The anchor-based method for determining the minimally important change (MIC) was used. GRoC and improvement on the items mobility and usual activities on the EQ-5D-5L served as external criteria. The scores on these anchors were used to categorize patients' physical functioning as improved or unchanged between 3 and 6 months after ATR. Receiver operating curve (ROC) analysis was performed, with the calculation of the area under the ROC curve (AUC) and the estimation of MIC values using the optimal cut-off points. RESULTS: There was a large change (ES: 1.58) and good responsiveness (SRM: 1.19) of the ATRS-NL between 3 and 6 months after ATR. Using ROC analysis, the MIC values ranged from 13.5 to 28.5 for reporting improvement on EQ-5D-5L mobility and GRoC, respectively. The AUC of improvement on mobility and improvement on GRoC were > 0.70. CONCLUSION: The ATRS-NL showed good responsiveness in ATR patients between 3 and 6 months after injury. Use of this questionnaire is recommended in clinical follow-up and longitudinal research of ATR patients. MIC values of 13.5 and 28.5 are recommended to consider ATR patients as improved and greatly improved between 3 and 6 months after ATR. LEVEL OF EVIDENCE: II