Investigation of the relationship between knee joint position sense and balance function and reaction time after total knee arthroplasty

Objective: The aim of this study was to evaluate and compare the joint position sense of individuals diagnosed with knee osteoarthritis (OA), unilateral total knee arthroplasty (TKA) for knee OA and healthy individuals and to investigate the effect of joint position sense on balance, physical performance, reaction time, kinesiophobia, pain, stiffness and function. Method: The study was carried out with 60 volunteers who were diagnosed with knee OA (n=20), total knee arthroplasty (n=20) and healthy (n=20). 'RateFastGonio®' phone application was used to evaluate joint position sense (EPS) at 15°, 45° and 60° angles, "Berg Balance Scale (BBS)" was used to evaluate balance, and "Nelson Foot Reaction Test" was used to evaluate reaction time, 'Timed Up and Go (TUG)' and "Stair Climb and Descend Test (SCDT)" were used to assess physical performance, "Tampa Kinesiophobia Scale (TKS)" was used to assess kinesiophobia, and "The Western Ontorio and Mc Master University Osteoarthritis Index (WOMAC)" questionnaire was used to assess pain, stiffness and physical capacity from the individual's perspective. Results: The results of our study showed that there was no statistically significant difference between the 3 groups in EPH and reaction time results and the results were similar (p>0.05). In Berg balance test examinations, it was observed that the values of the healthy group were significantly higher than the values of both the surgical and osteoarthritis groups (p<0.05). When reaction time examinations were analysed, it was observed that there was no statistically significant difference between the 3 groups (p>0.05). In the TUG and stair ascent and descent examinations, it was observed that the values of the healthy group were significantly lower than the values of both the surgical and osteoarthritis groups for both tests (p<0.05), and the values of the osteoarthritis group were significantly lower than the surgical group (p<0.05). In all kinesiophobia, pain, stiffness and function, the values of the healthy group were significantly lower than those of both the surgical and osteoarthritis groups (p<0.05). When the relationships of EPH values of 15°, 45° and 60° with other variables were analysed; no statistically significant relationship was found between the EPH values of 15°, 45° and 60° in any group and the parameters of Berg balance test, stair ascent and descent, kinesiophobia, pain, stiffness and function. However, in the osteoarthritis group, there was a statistically significant, positive and moderate relationship between EPH 60° values and reaction time values, and there was a statistically significant, positive and moderate relationship between EPH 15° values and TUG values in the healthy and osteoarthritis groups. Conclusion: In conclusion, since TKA and OA have been shown to worsen balance, physical performance and cause fear of movement, we suggest that their treatment should be directed to improve these parameters. In addition, although TKA was found to have a significant negative effect on EPH, it did not improve it. Considering that the elderly population is increasing, we suggest that preventive and therapeutic rehabilitation programmes including propiceptive exercise should be planned for both OA and TKA patients.