Patient Reported Outcomes following Elective Revision Total Knee Replacement

Aims and Objectives: The purpose was to evaluate the clinical outcomes of patients with knee osteoarthritis treated with bicompartmental arthroplasty (BKA) in comparison to unicompartmental (UKA), patellofemoral (PFA) and total knee arthroplasty (TKA) in a single center. Materials and Methods: This is a prospective study analyzing a consecutive series of 396 patients from two surgeons in a single center. In 191 men and 205 women either partial or total knee replacement were performed. Their mean age at surgery was 63±6,85 years and mean BMI 29,55±5,00 kg/m2. In 238 patients UKA, in 125 TKA, in 21 PFA and in 11 patients BKA was performed. Implants were cemented and made of cobalt chrome in partial knee and zirconium oxide in total knee replacement. Demographics and patient reported outcomes (VAS, KOOS, Oxford Knee Score (OKS)) were collected preoperatively and 3,6 and 12 months postoperatively. A total of 202 patients have thus far completed the 12 months follow-up time point. Results: All mean KOOS and OKS scores improved significantly 1 year after surgery (p<0.05). Mean preoperative aggregated KOOS improved from 49,0±14,1 to 74,3±17,8 in UKA, from 44,1±12,9 to 67,5±9,4 in PFA, from 46,1±15,1 to 71,0±14,8 in TKA and from 45,7±13,8 to 72,6±9,7 in BKA (p<0.05). Mean preoperative aggregated OKS improved from 25,1±7,6) to 38,5±9,7 in UKA, from 23,0±7,6 to 36,8±3,8 in PFA, from 23,4±8,2 to 37,3±8,1 in TKA and from 22,9±9,6 to 37,0±1,5 in BKA (p<0.05). The mean pain level (VAS)decreased from pre-treatment to 12 months after surgery in UKA from 5,5 to 1,6, in PFA from 6,1 to 2,5, in TKA from 6,0 to 1,9 and in BKA from 6,6 to 2,6. One patient (0.4%) underwent revision (at 3 month for inlay dislocation). Conclusion: This study shows excellent early clinical results of patients treated with unicompartmental, bicompartmental and total knee arthroplasty. Adherence to strict indications lead to a significant improvement of patient reported outcomes and a low revision rate one year postoperatively. The reported results for BKA are comparable to those of patients treated with unicompartmental arthroplasty. We conclude that bicompartmental arthroplasty is a safe and reliable surgery for patients with bicompartmental osteoarthritis.

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Prospective, observational study to evaluate the relation between patient-reported outcomes and component rotation in total knee replacement: protocol for the CRACK study

BMJ Open ◽

10.1136/bmjopen-2019-031166 ◽

2019 ◽

Vol 9 (11) ◽

pp. e031166

Author(s):

Hans-Peter van Jonbergen ◽

Ellie Landman ◽

Maarten Horst ◽

Robin Westerbeek ◽

Ydo Kleinlugtenbelt

Keyword(s):

Total Knee Replacement ◽

Clinical Outcomes ◽

Outcome Measures ◽

Knee Replacement ◽

Tibial Component ◽

Patient Reported Outcomes ◽

Persistent Pain ◽

Component Rotation ◽

Patient Reported ◽

Total Knee

IntroductionTotal knee replacement (TKR) for osteoarthritis results in a satisfactory outcome in the majority of patients, although up to one in five patients may be dissatisfied with the outcome. Persistent pain is a main contributor to patient dissatisfaction, and femoral and tibial component malrotation have been identified as a potential cause for both persistent pain and patellofemoral problems. Based on the assumption that component malrotation is the causative factor for persistent pain, early revision for patients with symptomatic malrotated components has been advocated in the literature. However, convincing evidence that component malrotation indeed results in less than optimal outcomes is lacking. This study aims to assess the relation between knee prosthesis component rotation and patient-reported outcomes in a large group of patients and to determine the range of femoral, tibial and combined rotation that results in the best clinical outcomes.Methods and analysisIn this single-centre, prospective observational cohort study, a total of 500 patients will undergo TKR. All patients will have a 3D-CT assessment of femoral and tibial component rotation within 8 weeks after surgery. Outcome measures will include the Oxford Knee Score, the Knee Injury and Osteoarthritis Outcome Score, EQ-5D, visual analogue scale for pain, the American Knee Society Score and the knee joint range of motion. We will assess the relation between femoral, tibial and combined component rotation and patient-reported outcome measures at 8 weeks and 1 year of follow-up, and we will determine the range of femoral, tibial and combined rotation that results in the best clinical outcomes.Ethics and disseminationEthical approval for this study has been granted by the Isala Hospital ethics committee. The results will be published in a peer-reviewed journal and presented at relevant meetings.Trial registration numberNL7635.

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Association Between Preoperative Radiographic Severity of Osteoarthritis and Patient-Reported Outcomes of Total Knee Replacement

JBJS Open Access ◽

10.2106/jbjs.oa.19.00073 ◽

2020 ◽

Vol 5 (3) ◽

pp. e19.00073-e19.00073

Author(s):

Jeffrey K. Lange ◽

Heidi Y. Yang ◽

Jamie E. Collins ◽

Elena Losina ◽

Jeffrey N. Katz

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Patient Reported Outcomes ◽

Radiographic Severity ◽

Patient Reported ◽

Total Knee

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Patient-Reported Outcomes After Total Knee Replacement Vary on the Basis of Preoperative Coexisting Disease in the Lumbar Spine and Other Nonoperatively Treated Joints

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.l.01007 ◽

2013 ◽

Vol 95 (20) ◽

pp. 1833-1837 ◽

Cited By ~ 47

Author(s):

David C. Ayers ◽

Wenjun Li ◽

Carol Oatis ◽

Milagros C. Rosal ◽

Patricia D. Franklin

Keyword(s):

Lumbar Spine ◽

Total Knee Replacement ◽

Knee Replacement ◽

Patient Reported Outcomes ◽

Patient Reported ◽

Total Knee

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Multiple joint involvement in total knee replacement for osteoarthritis: Effects on patient-reported outcomes

Arthritis Care & Research ◽

10.1002/acr.21629 ◽

2012 ◽

Vol 64 (6) ◽

pp. 838-846 ◽

Cited By ~ 43

Author(s):

A. V. Perruccio ◽

J. D. Power ◽

H. M. K. Evans ◽

S. R. Mahomed ◽

R. Gandhi ◽

...

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Patient Reported Outcomes ◽

Joint Involvement ◽

Patient Reported ◽

Total Knee

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The Association of Gait Kinematics, Instability and Patient Reported Outcomes in Patients With Total Knee Replacement

Case Medical Research ◽

10.31525/ct1-nct03896191 ◽

2019 ◽

Author(s):

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Patient Reported Outcomes ◽

Gait Kinematics ◽

Patient Reported ◽

Total Knee

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The Influence of Obesity on Patient Reported Outcomes following Total Knee Replacement

Arthritis ◽

10.1155/2012/185208 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 17

Author(s):

Vandana Ayyar ◽

Richard Burnett ◽

Fiona J. Coutts ◽

Marietta L. van der Linden ◽

Thomas H. Mercer

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Patient Reported Outcomes ◽

Short Form ◽

Oxford Knee Score ◽

Significant Group ◽

Change Scores ◽

Patient Reported ◽

Total Knee

This study retrospectively analysed the effects of obesity as described by Body Mass Index (BMI) on patient reported outcomes following total knee replacement. Participants (105 females and 66 males) who had undergone surgery under the care of a single surgeon were included in the review and were grouped according to their preoperative BMI into nonobese ( kg/m2), () obese ( kg/m2) (). Oxford Knee Score (OKS) and Short Form 12 scores (SF12) were taken preoperatively and 6 and 12 months after surgery to analyse differences between groups in the absolute scores as well as changes from before to after surgery. Preoperatively, the obese group had a significantly poorer OKS compared to non obese (44.7 versus 41.2, ). There were no statistically significant group effects on follow-up or change scores of the OKS and SF12. Correlations coefficients between BMI and follow-up and change scores were low (). There were no significant differences in the number of complications and revisions (local wound infection, 6.7% non obese, 11% obese, postoperative systemic complication, 8% non obese, 12% obese, revision, 4% nonobese, 3% obese). In conclusion, our findings indicate similar degrees of benefits from the surgery irrespective of patient BMI.

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