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FOTO Rehab Outcomes Blog

Subjective and Objective Measurements After Total Knee Arthroplasty


My hackles are raised. This abstract isn't very helpful because I have no idea what patient self reported outcome measurements were used. I do not believe the Timed Up and Go Test is the best test to use to correlate with outcomes when working with individuals who have had a knee joint replacement.

The Timed Up and Go Test was initially designed to determine risk of falling. The cut off point assesses the risk of falling. I'm not quite sure exactly how this test correlates with a patient self report outcome measure. As I sit here thinking about older adults I have treated who had a knee replacement, I can assure you, their Timed Up and Go Test looked fantastic, yet their FOTO score wasn't at the predicted score.

What these investigators should have done is used something more like gait speed versus the Timed Up and Go Test. Gait speed has predetermined parameters that can be projected into a person's functional ambulation ability. 

Here's a quick view of the abstract. 


Subjective and objective outcome measures after total knee replacement: is there a correlation?



Although various methods for quantifying outcomes following total knee replacement (TKR) are used, there are few studies of the relationships between patient reported scores and functional tests. This paper aims to assess the relationships between commonly used outcome scores after TKR through a prospective cohort study.


Twenty-four patients who had undergone unilateral TKR were assessed using four patient-reported outcome scores as well as objective measurements of knee laxity, quadriceps muscle strength and the Timed Up and Go Test. All scores and measures were correlated using the Pearson product moment correlation coefficient using the lower one-sided 95% confidence interval. A level of significance of P < 0.05 was selected.


The Timed Up and Go Test was the only objective measure to demonstrate a statistically significant correlation (r = -0.557 to -0.770, P = 0.0001-0.005) with patient-reported scores.


A comprehensive assessment of outcomes after TKR requires both subjective and objective assessments. Walking ability and speed are important to the TKR patient and are representative of their pain and function.

  2016 Nov;86(11):921-925. doi: 10.1111/ans.13708. Epub 2016 Aug 25.