Do lifestyle factors affect patient reported clinical outcomes after total knee replacement surgery? A feasibility cohort study (PRO-Knee)

Aims To evaluate the feasibility of a substantive cohort study to determine whether modifiable lifestyle factors, including smoking, physical inactivity, alcohol consumption and being overweight, affect patient-reported clinical outcomes after total knee replacement surgery. Methods Adults awaiting total knee replacement surgery were recruited pre-operatively and completed self-reported questionnaires at baseline and 3- and 6-months post-surgery. Feasibility outcomes, including recruitment, retention and response rate of the primary outcome questionnaire were analysed descriptively. Results 40 participants were recruited from 183 eligible patients (22%). 87.5% (35/40) participants returned questionnaires at 6-months. 85% (34/40) of participants were overweight (BMI > 24.9), 25% (10/40) drank alcohol (AUDIT-C > 4), 5% (2/40) smoked tobacco and 67.5% (27/40) were physically inactive (GPPAQ classification of ‘moderately inactive’, or ‘inactive’). Conclusion Modifiable lifestyle factors including smoking, alcohol use, physical inactivity and being overweight are highly prevalent in patients waiting for total knee replacement. Based on this study, a future substantive cohort study investigating the effect of lifestyle factors on clinical outcomes post total knee replacement in the UK NHS is feasible.