scholarly journals Mid-long term  results of total knee arthroplasty followed by ipsilateral total hip arthroplasty versus total hip arthroplasty subsequent to ipsilateral total knee arthroplasty: A retrospective cohort study

2020 ◽  
Author(s):  
Zunhan Liu ◽  
Wei-Nan Zeng ◽  
Zhenyu Luo ◽  
Enze Zhao ◽  
Hao Li ◽  
...  

Abstract Background Total hip arthroplasty (THA) altered the mechanical axis and loading distribution of the lower extremity. The effect of a prior THA on clinical outcomes of a subsequent ipsilateral total knee arthroplasty (TKA) remains unknown. Methods We reviewed 83 patients who underwent ipsilateral THA and TKA for rheumatoid arthritis or osteoarthritis between January 2008 and April 2014. Forty-seven patients were classified as TKA followed by ipsilateral THA (THA-TKA group) and 36 as THA subsequent to ipsilateral TKA (TKA-THA group). Twenty-eight patients (30 hips and knees) were selected for each group after the propensity score was matched with preoperative demographics and hip-knee-ankle angle (HKA). Clinical measurements, radiographic evaluations, and complication data were compared between 2 groups. Results Both groups had a significant improvement in modified Harris Hip Scores (HHS), Knee Society Score (KSS), and Short Form-12 at final follow-up compared to baseline (p < .001). The clinical parameters were actually lower in THA-TKA group. However, those differences were not significant (p > .05). Meanwhile, there was no significant difference in postoperative radiographic axial alignment and implant survivorship (90.0% vs 96.7%, p = .305). The rate of complication was also similar in both groups. Conclusions A prior THA does not appear to influence clinical outcome of a subsequent ipsilateral TKA. Patients with different sequence of ipsilateral THA and TKA have similar mid-long term clinical outcomes and implant survivorship. Trial registration: The trial was registered in the Chinese Clinical Trial Registry (ChiCTR2000035147) dated 2rd August 2020.

Author(s):  
Xiao Rong ◽  
Suraj Dahal ◽  
Ze-yu Luo ◽  
Kai Zhou ◽  
Shun-Yu Yao ◽  
...  

Abstract Background Performing total joint arthroplasty (TJA) in Parkinson’s disease (PD) patients may encounter a higher complication rate or worse functional outcomes compared with common patients. The relationship between PD and clinical outcomes after TJA is not fully understood. Methods Retrospectively, we used manual charts to investigate the clinical outcomes in 41 patients including 24 total hip arthroplasty (THA) patients (28 hips) and 18 total knee arthroplasty (TKA) patients (22 knees) with a diagnosis of PD from 2009 to 2016. The stage of PD was confirmed by Hoehn and Yahr scale. Prosthesis survivorship was estimated with revision for any reason as the endpoint. Result All the clinical outcomes improved significantly (p < 0.05). Subgroup analysis revealed worse functional outcomes in mid- or end-stage PD patients. Sixteen short-term mild to moderate complications were noted. Two revisions were conducted for hip periprosthetic osteolysis and postoperative knee pain. The prosthesis survivorship at 60 months for TJA, total hip arthroplasty (THA), or total knee arthroplasty (TKA) was 91.6%, 94.1%, and 87.5%, respectively. Conclusion Patients with PD who underwent TJA would result in excellent pain relief and gain of function. However, patients at late-stage PD may suffer from functional loss. The effectiveness of TJA in patients with severe PD remains a concern. Physician should help delay the progression of PD which may optimize and stabilize the functional outcomes of TJA.


2020 ◽  
Vol 04 (02) ◽  
pp. 084-089
Author(s):  
Vivek Singh ◽  
Stephen Zak ◽  
Ran Schwarzkopf ◽  
Roy Davidovitch

AbstractMeasuring patient satisfaction and surgical outcomes following total joint arthroplasty remains controversial with most tools failing to account for both surgeon and patient satisfaction in regard to outcomes. The purpose of this study was to use “The Forgotten Joint Score” questionnaire to assess clinical outcomes comparing patients who underwent a total hip arthroplasty (THA) with those who underwent a total knee arthroplasty (TKA). We conducted a retrospective review of patients who underwent primary THA or TKA between September 2016 and September 2019 and responded to the Forgotten Joint Score-12 (FJS-12) questionnaire at least at one of three time periods (3, 12, and 21 months), postoperatively. An electronic patient rehabilitation application was used to administer the questionnaire. Collected variables included demographic data (age, gender, race, body mass index [BMI], and smoking status), length of stay (LOS), and FJS-12 scores. t-test and chi-square were used to determine significance. Linear regression was used to account for demographic differences. A p-value of less than 0.05 was considered statistically significant. Of the 2,359 patients included in this study, 1,469 underwent a THA and 890 underwent a TKA. Demographic differences were observed between the two groups with the TKA group being older, with higher BMI, higher American Society of Anesthesiologists scores, and longer LOS. Accounting for the differences in demographic data, THA patients consistently had higher scores at 3 months (53.72 vs. 24.96; p < 0.001), 12 months (66.00 vs. 43.57; p < 0.001), and 21 months (73.45 vs. 47.22; p < 0.001). FJS-12 scores for patients that underwent THA were significantly higher in comparison to TKA patients at 3, 12, and 21 months postoperatively. Increasing patient age led to a marginal increase in FJS-12 score in both cohorts. With higher FJS-12 scores, patients who underwent THA may experience a more positive evolution with their surgery postoperatively than those who had TKA.


2021 ◽  
Author(s):  
Naofumi Taniguchi ◽  
Tetsuya Jinno ◽  
Tetsuro Ohba ◽  
Hiroshi Endo ◽  
Masanori Wako ◽  
...  

ABSTRACT Objectives To clarify the longitudinal changes in patients with preoperative Stage-3 locomotive syndrome (LS) according to different types of surgeries, we investigated the changes in the LS stage in patients who underwent surgery for degenerative musculoskeletal diseases. Methods A prospective cohort study was conducted on 168 patients with degenerative diseases [46 spinal deformities treated with thoracolumbar interbody fusion (T/LIF), 86 hips with osteoarthritis treated with total hip arthroplasty (THA), and 36 knees with osteoarthritis treated with total knee arthroplasty (TKA)]. The results for the LS stage, stand-up test, two-step test, and 25-question Geriatric Locomotive Function Scale (GLFS-25) were evaluated preoperatively and at 6 months, 1 year, and 2 years postoperatively. Results Preoperatively, most patients had Stage-3 LS (89.1, 90.8, and 80.6% in the T/LIF, THA, and TKA groups, respectively). At 2 years postoperatively, the Stage-3 LS improved in 41.5, 75.6, and 55.2% of patients in the T/LIF, THA, and TKA groups, respectively. All groups showed similar improvements in the two-step test. The THA group showed the best result in the GLFS-25. Conclusions LS stage improved in different patterns over 2 years postoperatively and the LS risk test revealed differences in postoperative movement ability according to the type of surgery.


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