Knee Injury and Osteoarthritis Outcome Score has higher responsiveness and lower ceiling effect than Knee Society Function Score after total knee arthroplasty

Abstract Background The aim of this study was to compare the mid-term clinical and radiographic outcomes between medial-pivotal (MP) insert and double-high (DH) insert used under cruciate-retaining condition in ADVANCE® total knee arthroplasty (TKA). Methods The follow-up was conducted for 158 consecutive patients underwent unilateral ADVANCE® TKA from January 2011 to April 2014. 84 MP inserts and 74 DH inserts were used under cruciate-retaining condition. A 1:1 propensity score matching (PSM) analysis was performed between MP insert and DH insert to compare the clinical and radiographic outcomes. Results After a 1:1 PSM, 120 patients (60 pairs) were matched between MP insert and DH insert. The baseline demographic parameters and clinical scores were comparable between the two groups. The postoperative clinical outcomes at an averaged 8-year follow-up of both groups were significantly improved. The range of motion (ROM) of DH group was better than that of MP group and equivalent Knee Society Function Score (KSFS) between the two groups was found. However, the Knee Society Score (KSS), Western Ontario and McMaster Universities Arthritis Index (WOMAC) score and Forgotten Joint Score (FJS) of MP group were found to be significantly superior than those of DH group. Comparable complication rate and revision rate were observed between the two groups. The radiographic results were also equally good between MP and DH group. Conclusions Although the mid-term clinical and radiographic outcomes of DH insert are fairly good, the clinical scores of DH group were worse than those of MP group.

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Prospective randomized trial of standard versus highly crosslinked tibial polyethylene in primary posterior-stabilized total knee arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.101b7.bjj-2018-1126.r2 ◽

2019 ◽

Vol 101-B (7_Supple_C) ◽

pp. 33-39 ◽

Cited By ~ 3

Author(s):

P. F. Lachiewicz ◽

J. A. O’Dell

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Randomized Study ◽

Posterior Stabilized ◽

Function Score ◽

Score Change ◽

Osteolytic Lesions ◽

Significant Difference ◽

Total Knee

Aims There is insufficient evidence to recommend the use of alternative polyethylene bearings in modular, fixed-bearing total knee arthroplasty (TKA). The purpose of this study was to compare standard polyethylene (SP) and highly crosslinked polyethylene (XLP) tibial liners in posterior-stabilized TKA, with osteolysis as the primary outcome and clinical results and the rate of re-operation as the secondary outcomes. Patients and Methods This is a single-surgeon, prospective randomized study involving one design of modular posterior-stabilized TKA. An analysis of 122 TKAs with an SP compression moulded liner and 123 with an XLP liner was performed, with a mean follow-up of six years (2 to 11). Patients were evaluated clinically using the Knee Society score, Lower Extremity Activity Score (LEAS), and the presence of an effusion, and standard radiographs were assessed for radiolucent lines and osteolytic lesions. Results Osteolysis was present in four TKAs (3.3%) in the SP group, and no knees in the XLP group (p = 0.06). There were no significant differences between the Knee Society total score, change in total score, knee function score, change in function score, LEAS, and change in LEAS in the two groups. There was a significant difference in the presence of an effusion (10/122 with SP liners, 1/123 with XLP liners; p = 0.02). There was no significant difference in the rate of re-operation between the two groups (p = 0.36). There were no complications related to the XLP liner. Conclusion At this length of follow-up, there were no advantages and no complications related to the use of this XLP tibial liner. The presence of effusion and small osteolytic lesions was more frequent with SP than XLP liners, but of unknown clinical significance. Cite this article: Bone Joint J 2019;101-B(7 Supple C):33–39

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A performance based patient outcome score for active patients following total knee arthroplasty

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2012.09.019 ◽

2013 ◽

Vol 21 (1) ◽

pp. 51-59 ◽

Cited By ~ 13

Author(s):

F.S. Hossain ◽

S. Patel ◽

M.A. Fernandez ◽

S. Konan ◽

F.S. Haddad

Keyword(s):

Patient Outcome ◽

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Outcome Score ◽

Total Knee ◽

Active Patients ◽

A Performance

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Predicting clinical outcomes after total knee arthroplasty from preoperative radiographic factors of the knee osteoarthritis

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-3029-7 ◽

2020 ◽

Vol 21 (1) ◽

Cited By ~ 1

Author(s):

Kaoru Toguchi ◽

Arata Nakajima ◽

Yorikazu Akatsu ◽

Masato Sonobe ◽

Manabu Yamada ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Patient Reported Outcomes ◽

Knee Injury ◽

Postoperative Patient ◽

Radiographic Measurements ◽

Patient Reported ◽

Total Knee ◽

End Stage

Abstract Background Total knee arthroplasty (TKA) is the major surgical treatment for end-stage osteoarthritis (OA). Despite its effectiveness, there are about 20% of patients who are dissatisfied with the outcome. Predicting the surgical outcome preoperatively could be beneficial in order to guide clinical decisions. Methods One-hundred and ten knees of 110 consecutive patients who underwent TKAs for varus knees resulting from OA were included in this study. Preoperative varus deformities were evaluated by femorotibial angle (FTA), medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA), and classified as a severe varus (SV) or a mild varus (MV) group. The osteophyte score (OS), which we developed originally, was also calculated based on the size of the osteophytes and classified as groups with more or less osteophytes. We compared preoperative and 1-year postoperative range of motion, the Knee Society Score, and Japanese Knee injury Osteoarthritis Outcome Score (KOOS) between SV and MV groups (varus defined by FTA, MPTA, or LDFA), in each group with more or less osteophytes. Results When varus deformities were defined by FTA, regardless of OS, postoperative KOOS subscales and/or the improvement rates were significantly higher in the SV group than in the MV group. When varus defined by MPTA, regardless of OS, there were no significant differences in postoperative KOOS subscales between groups. However, when varus defined by LDFA, scores for pain, activities of daily living (ADL), and quality of life (QOL) on postoperative KOOS and/or the improvement rates were significantly higher in the SV group than in the MV group only in patients with less osteophytes. No significant differences were found between groups in patients with more osteophytes. Conclusions We classified OA types by radiographic measurements of femur and tibia in combination with OS. Postoperative patient-reported outcomes were better in patients with SV knees but were poor in patients with knees with MV deformity and less osteophytes.

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