scholarly journals Similar outcomes in computer-assisted and conventional total knee arthroplasty: ten-year results of a prospective randomized study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Franziska Beyer ◽  
Alexander Pape ◽  
Cornelia Lützner ◽  
Stephan Kirschner ◽  
Jörg Lützner
Keyword(s):  
Randomized Study ◽  
Patient Reported Outcome Measures ◽  
Conventional Technique ◽  
Patient Reported Outcome ◽  
Long Term Results ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Accuracy And Precision ◽  
Patient Reported ◽  
Total Knee

Abstract Background Computer-assisted navigation (CAS) was developed to improve the surgical accuracy and precision. Many studies demonstrated better alignment in the coronal plane in CAS TKA compared to conventional technique. The influence on the functional outcome is still unclear. Only few studies report long-term results of CAS TKA. This study was initiated to investigate 10-year patient-reported outcome of CAS and conventional TKA. Methods From initially 80 patients of a randomized study of CAS and conventional TKA a total of 50 patients could be evaluated at the 10-year follow-up. The Knee Society Score and EuroQuol Questionnaire were assessed. For all patients a competing risk analysis for revision was performed. Results The patient-reported outcome measures demonstrated similar values for both groups. The 10-year risk for revision was 2.5% for conventional TKA and 7.5% for CAS TKA (p=0.237). Conclusions There was no difference between CAS and conventional TKA with regard to patient-reported outcome and revision risk ten years after surgery. Trial registration This study was registered at clinicaltrials.gov on 11/30/2009, ID: NCT01022099.

scholarly journals PROMs in total knee replacement: analysis of negative outcomes

2021 ◽  
Vol 103 (1) ◽  
pp. 64-73
Author(s):  
F Begum ◽  
A Panagiotidou ◽  
C Park ◽  
T Ashdown ◽  
S El-Tawil
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Oxford Knee Score ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Replacement Policy ◽  
Health Gains ◽  
Patient Reported ◽  
Post Operation ◽  
Total Knee

Introduction NHS England uses the Oxford Knee Score (OKS) as part of patient-reported outcome measures (PROMs) to evaluate ‘health gains’ following total knee replacement. Policy makers use this to guide healthcare funding and resource allocation. Our study aims to undertake a qualitative and quantitative analysis of OKS among patients who experienced a negative outcome after a total knee replacement at our centre. Materials and methods Between April 2017-March 2018, 19 of 189 (10%) patients had a worsened OKS at our centre. We retrospectively and prospectively reviewed 14 of these patients. Structured telephone interviews with a repeat OKS were carried out in September 2019 (18–29 months post-operation). Results Eight patients were female and the total age range was 57–95, mean average 75.6 (SD 9.9 years). Of 48 (higher scores meaning better outcomes), the average preoperative OKS was 24.2 and the average postoperative OKS at 6 months was 19.4 (decrease of 20%). The average postoperative OKS at 18–29 months was 35.6 (an increase of 83.5% from 6 months). Discussion The OKS was developed and validated over 20 years ago in Oxford. In our study, four patients asked for clarification of questions 4, 6 and 10 owing to ambiguous language. All 14 patients who had negative OKS outcomes had positive outcomes when retested after 18 months, depicting ‘health gains’ not conveyed in PROMs analysis. Conclusion The OKS needs to be revalidated on current patient groups for accurate and reliable data. Further prospective studies should be undertaken on larger cohorts to understand the recovery course and whether PROMs should be carried out later.

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