SAT0505 Self-reported knee instability associated with pain and activity limitations prior and one year after total knee arthroplasty in patients with knee osteoarthritis

Purpose To evaluate the regression of fear of falling (FOF) and identify its risk factors in patients with severe knee osteoarthritis before and one year after total knee arthroplasty (TKA). Methods 11 men and 57 women with a mean age of 73 years and a mean body mass index of 30.36 kg/m2 who had severe (grade 3 or 4) knee osteoarthritis and knee pain of ≥1 year were included. Two weeks before and one year after TKA, patients were asked about their FOF status and falls history. Patients were asked to complete the Physical Activity Scale for the Elderly, Short Form 36 (SF-36), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaires. Clinical performance was assessed using the Berg Balance Scale and Timed Up and Go (TUG) test. Results Of the 68 patients, 56 (82.4%) had FOF preoperatively and 30 (44.1%) had FOF one year after TKA (p<0.001). The strongest predictors for FOF preoperatively were fallers (odds ratio [OR]=9.83, p=0.028), mental component summary (MCS) score of SF-36 (OR=0.88, p=0.024), and TUG (OR=3.4, p=0.013). The strongest predictors for FOF one year postoperatively were fallers (OR=16.51, p=0.041), patients with ≥2 chronic diseases (OR=17.33, p=0.011), physical function score of WOMAC (OR=1.015, p=0.005), and MCS score of SF-36 (OR=0.86, p=0.015). Conclusion TKA positively affected FOF and gradually reduced the FOF rate over a year period after TKA in an elderly population.

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A comparison of balance and fall risk in patients with unilateral and bilateral total knee arthroplasty

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-210127 ◽

2021 ◽

pp. 1-9

Author(s):

Erman Tütüncüler ◽

Nusret Ök ◽

Harun Reşit Güngör ◽

Gökhan Bayrak ◽

Raziye Şavkın ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Osteoarthritis ◽

Knee Arthroplasty ◽

Fall Risk ◽

Activity Limitations ◽

Stand Test ◽

Increased Risk ◽

Patient Reported ◽

Total Knee ◽

And Performance

BACKGROUND: Static or dynamic postural control cannot be fully restored in patients with knee osteoarthritis, even after total knee arthroplasty (TKA), which may contribute to an increased risk of falls in the elderly. OBJECTIVE: To evaluate balance and the fall risk before and after TKA in patients with bilateral knee osteoarthritis. Secondary outcomes were patient-reported and performance-based activity limitations. METHODS: A total of 45 patients were separated into two groups as unilateral TKA (UTKA, n= 24) and bilateral TKA (BTKA, n= 21) groups. All the patients received standard postoperative physical therapy for 3 months. Balance and fall risk (Biodex Balance System SD), patient-reported and performance-based functionality (WOMAC, 30-second chair-stand test, 9-step stair climbing test and 40-meter fast-paced walk test) and Short Form-12 (SF-12) were evaluated at preoperatively, and at 3 months postoperatively. RESULTS: There was no difference between the groups in postoperative fall risk and balance (p> 0.05). The BTKA group obtained better results in the sit-to-stand test and SF-12 physical dimension (p< 0.05). CONCLUSIONS: UTKA and BTKA interventions and the standard postoperative rehabilitation were seen to improve balance and quality of life, and reduce the fall risk, patient-reported and performance-based activity limitations. However, despite improvements in balance, the risk of falling persists.

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Pros and cons of navigated versus conventional total knee arthroplasty—a retrospective analysis of over 2400 patients

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03834-y ◽

2021 ◽

Author(s):

Matthias Meyer ◽

Tobias Renkawitz ◽

Florian Völlner ◽

Achim Benditz ◽

Joachim Grifka ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Retrospective Analysis ◽

Outcome Measures ◽

Knee Arthroplasty ◽

Mechanical Axis ◽

Complication Rates ◽

Total Knee ◽

One Year ◽

Navigated Tka ◽

Surgery Duration

Abstract Introduction Because of the ongoing discussion of imageless navigation in total knee arthroplasty (TKA), its advantages and disadvantages were evaluated in a large patient cohort. Methods This retrospective analysis included 2464 patients who had undergone TKA at a high-volume university arthroplasty center between 2012 and 2017. Navigated and conventional TKA were compared regarding postoperative mechanical axis, surgery duration, complication rates, one-year postoperative patient-reported outcome measures (PROMs) (WOMAC and EQ-5D indices), and responder rates as defined by the criteria of the Outcome Measures in Rheumatology and Osteoarthritis Research Society International consensus (OMERACT-OARSI). Results Both navigated (1.8 ± 1.6°) and conventional TKA (2.1 ± 1.6°, p = 0.002) enabled the exact reconstruction of mechanical axis. Surgery duration was six minutes longer for navigated TKA than for conventional TKA (p < 0.001). Complication rates were low in both groups with comparable frequencies: neurological deficits (p = 0.39), joint infection (p = 0.42 and thromboembolic events (p = 0.03). Periprosthetic fractures occurred more frequently during conventional TKA (p = 0.001). One-year PROMs showed excellent improvement in both groups. The WOMAC index was statistically higher for navigated TKA than for conventional TKA (74.7 ± 19.0 vs. 71.7 ± 20.7, p = 0.014), but the increase was not clinically relevant. Both groups had a similarly high EQ-5D index (0.23 ± 0.24 vs. 0.26 ± 0.25, p = 0.11) and responder rate (86.5% [256/296] vs. 85.9% [981/1142], p = 0.92). Conclusion Both methods enable accurate postoperative leg alignment with low complication rates and equally successful PROMs and responder rates one year postoperatively. Level of evidence III. Retrospective cohort study.

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Circulating surgery-induced gene signatures are associated with recovery from total knee arthroplasty for knee osteoarthritis

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2021.02.461 ◽

2021 ◽

Vol 29 ◽

pp. S355-S356

Author(s):

M.A. Kirksey ◽

S.G. Lessard ◽

M. Khan ◽

G.A. Birch ◽

D. Oliver ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Osteoarthritis ◽

Knee Arthroplasty ◽

Gene Signatures ◽

Total Knee

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Age and Sex Differences in Knee Osteoarthritis Patients’ Expectations of Total Knee Arthroplasty

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2017.02.585 ◽

2017 ◽

Vol 25 ◽

pp. S346 ◽

Cited By ~ 1

Author(s):

G.A. Hawker ◽

D. Marshall ◽

A. Jones ◽

L. Woodhouse ◽

B. Ravi ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Sex Differences ◽

Knee Osteoarthritis ◽

Knee Arthroplasty ◽

Total Knee ◽

Age And Sex

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No associations between self-reported knee joint instability and radiographic features in knee osteoarthritis patients prior to Total Knee Arthroplasty: A cross-sectional analysis of the Longitudinal Leiden Orthopaedics Outcomes of Osteo-Arthritis study (LOAS) data

The Knee ◽

10.1016/j.knee.2017.04.001 ◽

2017 ◽

Vol 24 (4) ◽

pp. 816-823 ◽

Cited By ~ 8

Author(s):

Claudia S. Leichtenberg ◽

Jorit J.L. Meesters ◽

Herman M. Kroon ◽

Suzan H.M. Verdegaal ◽

Claire Tilbury ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Joint ◽

Knee Osteoarthritis ◽

Knee Arthroplasty ◽

Joint Instability ◽

Cross Sectional ◽

Radiographic Features ◽

Cross Sectional Analysis ◽

Total Knee ◽

Sectional Analysis

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Venous thromboembolism after total knee arthroplasty is associated with a worse functional outcome at one year

The Bone & Joint Journal ◽

10.1302/0301-620x.103b7.bjj-2019-0636.r7 ◽

2021 ◽

Vol 103-B (7) ◽

pp. 1254-1260

Author(s):

Lorenzo Calabro ◽

Nick D. Clement ◽

Deborah MacDonald ◽

James T. Patton ◽

Colin R. Howie ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Patient Satisfaction ◽

Venous Thromboembolism ◽

Functional Outcome ◽

Knee Arthroplasty ◽

Oxford Knee Score ◽

Significant Independent Predictor ◽

Total Knee ◽

Five Dimension ◽

One Year

Aims The primary aim of this study was to assess whether non-fatal postoperative venous thromboembolism (VTE) within six months of surgery influences the knee-specific functional outcome (Oxford Knee Score (OKS)) one year after total knee arthroplasty (TKA). Secondary aims were to assess whether non-fatal postoperative VTE influences generic health and patient satisfaction at this time. Methods A study of 2,393 TKAs was performed in 2,393 patients. Patient demographics, comorbidities, OKS, EuroQol five-dimension score (EQ-5D), and Forgotten Joint Score (FJS) were collected preoperatively and one year postoperatively. Overall patient satisfaction with their TKA was assessed at one year. Patients with VTE within six months of surgery were identified retrospectively and compared with those without. Results A total of 37 patients (1.5%) suffered a VTE and were significantly more likely to have associated comorbidities of stroke (p = 0.026), vascular disease (p = 0.026), and kidney disease (p = 0.026), but less likely to have diabetes (p = 0.046). In an unadjusted analysis, patients suffering a VTE had a significantly worse postoperative OKS (difference in mean (DIM) 4.8 (95% confidence interval (CI) 1.6 to 8.0); p = 0.004) and EQ-5D (DIM 0.146 (95% CI 0.059 to 0.233); p = 0.001) compared with patients without a VTE. After adjusting for confounding variables VTE remained a significant independent predictor associated with a worse postoperative OKS (DIM -5.4 (95% CI -8.4 to -2.4); p < 0.001), and EQ-5D score (DIM-0.169 (95% CI -0.251 to -0.087); p < 0.001). VTE was not independently associated with overall satisfaction after TKA (odds ratio 0.89 (95% CI 0.35 to 2.07); p = 0.717). Conclusion Patients who had a VTE within six months of their TKA had clinically significantly worse knee-specific outcome (OKS) and general health (EQ-5D) scores one year postoperatively, but the overall satisfaction with their TKA was similar to those patients who did not have a VTE. Cite this article: Bone Joint J 2021;103-B(7):1254–1260.

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