ACTION Trial: The goal attainment scaling for knee arthroplasty in younger patients

PROJECT PARTNERS

· This project is a single center study performed at the Amphia hospital, Breda, The Netherlands

FUNDING

· The study was funded by Foundation NuthsOhra (grant number 1403-026).  

BACKGROUND

Knee arthroplasty (KA) has proven to be a reliable treatment to relieve pain, improve function and enhance health-related quality of life in patients suffering from knee osteoarthritis (OA). Following the increasing prevalence of knee OA, the demand for KA is expected to rise worldwide, especially in patients 55 – 65 years of age. These patients often wish to return to work and to participate in knee-demanding leisure time activities. Despite the aforementioned benefits of KA, up to 20% of patients remain dissatisfied after surgery.

Unmet expectations are the primary cause for dissatisfaction after KA, and rehabilitation likely plays a crucial role in establishing and obtaining reasonable goals. Since younger KA patients have a wide variety of activity goals and expectations, a ‘one-size-fits-all’ rehabilitation approach likely does not suffice. A possible instrument to tailor the rehabilitation to patients’ personal goals is Goal Attainment Scaling (GAS). Theoretically, GAS could prove to be a useful instrument to establish realistic goals, increase goal attainment and thus improve satisfaction in younger KA patients.

OBJECTIVES

We will investigate the effect of GAS-based rehabilitation on satisfaction in younger, active KA patients. We hypothesize that a GAS-based, personalized, goal-directed rehabilitation leads to higher satisfaction scores for postoperative performance of activities, compared to usual-care rehabilitation after KA.

FURTHER INFORMATION

Witjes S, Hoorntje A, Kuijer PP, Koenraadt KL, Blankevoort L, Kerkhoffs GM, van Geenen RC. Does Goal Attainment Scaling improve satisfaction regarding performance of activities of younger knee arthroplasty patients? Study protocol of the randomized controlled ACTION trial. BMC Musculoskelet Disord. 2016 Mar 2;17:113. doi: 10.1186/s12891-016-0965-3. PMID: 26936270

Hoorntje A, Witjes S, Kuijer PPFM, Bussmann JBJ, Horemans HLD, Kerkhoffs GMMJ, van Geenen RCI, Koenraadt KLM. Does Activity-Based Rehabilitation With Goal Attainment Scaling Increase Physical Activity Among Younger Knee Arthroplasty Patients? Results From the Randomized Controlled ACTION Trial. J Arthroplasty. 2019 Oct 23. pii: S0883-5403(19)31005-8. doi: 10.1016/j.arth.2019.10.028. [Epub ahead of print]. PMID:31740103

Witjes S, Hoorntje A, Kuijer PP, Koenraadt KL, Blankevoort L, Kerkhoffs GM, van Geenen RC. Goal Setting and Achievement in Individualized Rehabilitation of Younger Total and Unicondylar Knee Arthroplasty Patients: A Cohort Study. Arch Phys Med Rehabil. 2019 Aug;100(8):1434-1441. doi: 10.1016/j.apmr.2018.11.019. Epub 2018 Dec 22. PMID: 30582918