Impact of Preoperative Total Knee Arthroplasty on Radiological and Clinical Outcomes of Spinal Fusion for Concurrent Knee Osteoarthritis and Degenerative Lumbar Spinal Diseases

Concurrent knee osteoarthritis (KOA) and degenerative lumbar spinal disease (LSD) has increased, but the total knee arthroplasty (TKA) effect on degenerative LSD remains unclear. The aim of this study was to retrospectively analyze to compare radiological and clinical outcomes between spinal fusion only and preoperative TKA with spinal fusion for the patients with concurrent KOA and degenerative LSD. A total of 72 patients with concurrent KOA and degenerative LSDs who underwent spinal fusion at less than three levels were divided in two groups: non-TKA group (n = 50) and preoperative TKA group (n = 22). Preoperative lumbar lordosis (LL) was significantly lower in the preoperative TKA group than the non-TKA group (p < 0.05). Significantly higher preoperative pelvic incidence (PI), PI/LL mismatch, and pelvic tilt (PT) occurred in preoperative TKA group than non-TKA group (all p < 0.05). There was significant improvement of postoperative Oswestry Disability Index and leg Visual Analog Scale in the preoperative TKA group (all p < 0.01). Preoperative TKA could be a benefit for in proper correction of sagittal spinopelvic alignment by spinal fusion. Therefore, preoperative TKA could be considered a preceding surgical option for patients with severe sagittal spinopelvic parameters in concurrent KOA and degenerative LSD.

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Knee extension disturbance of knee osteoarthritis effect the short-term clinical outcomes after total knee arthroplasty

Physiotherapy ◽

10.1016/j.physio.2015.03.3323 ◽

2015 ◽

Vol 101 ◽

pp. e518-e519

Author(s):

K. Hanada ◽

A. Fujii ◽

Y. Shimamoto

Keyword(s):

Total Knee Arthroplasty ◽

Knee Osteoarthritis ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Knee Extension ◽

Short Term ◽

Total Knee

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Severity of valgus knee osteoarthritis has no effect on clinical outcomes after total knee arthroplasty

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03785-4 ◽

2021 ◽

Author(s):

Kilian Rueckl ◽

Armin Runer ◽

Anna Jungwirth-Weinberger ◽

Maximilian F. Kasparek ◽

Martin Faschingbauer ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Osteoarthritis ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Valgus Knee ◽

Total Knee

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Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction

The Journal of Knee Surgery ◽

10.1055/s-0040-1709675 ◽

2020 ◽

Author(s):

Jung-Won Lim ◽

Yong-Beom Park ◽

Dong-Hoon Lee ◽

Han-Jun Lee

Keyword(s):

Total Knee Arthroplasty ◽

Patient Satisfaction ◽

Clinical Outcome ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Knee Flexion ◽

Functional Score ◽

Manipulation Under Anesthesia ◽

Total Knee

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.

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Over-constrained kinematic of the medial compartment leads to lower clinical outcomes after total knee arthroplasty

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-020-06398-3 ◽

2021 ◽

Author(s):

Nicola Pizza ◽

Stefano Di Paolo ◽

Raffaele Zinno ◽

Giulio Maria Marcheggiani Muccioli ◽

Piero Agostinone ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Motor Task ◽

Medial Compartment ◽

Level Of Evidence ◽

Contact Points ◽

Sit To Stand ◽

Medial Pivot ◽

Total Knee

Abstract Purpose To investigate if postoperative clinical outcomes correlate with specific kinematic patterns after total knee arthroplasty (TKA) surgery. The hypothesis was that the group of patients with higher clinical outcomes would have shown postoperative medial pivot kinematics, while the group of patients with lower clinical outcomes would have not. Methods 52 patients undergoing TKA surgery were prospectively evaluated at least a year of follow-up (13.5 ± 6.8 months) through clinical and functional Knee Society Score (KSS), and kinematically through dynamic radiostereometric analysis (RSA) during a sit-to-stand motor task. Patients received posterior-stabilized TKA design. Based on the result of the KSS, patients were divided into two groups: “KSS > 70 group”, patients with a good-to-excellent score (93.1 ± 6.8 points, n = 44); “KSS < 70 group”, patients with a fair-to-poor score (53.3 ± 18.3 points, n = 8). The anteroposterior (AP) low point (lowest femorotibial contact points) translation of medial and lateral femoral compartments was compared through Student’s t test (p < 0.05). Results Low point AP translation of the medial compartment was significantly lower (p < 0.05) than the lateral one in both the KSS > 70 (6.1 mm ± 4.4 mm vs 10.7 mm ± 4.6 mm) and the KSS < 70 groups (2.7 mm ± 3.5 mm vs 11.0 mm ± 5.6 mm). Furthermore, the AP translation of the lateral femoral compartment was not significantly different (p > 0.05) between the two groups, while the AP translation of the medial femoral compartment was significantly higher for the KSS > 70 group (p = 0.0442). Conclusion In the group of patients with a postoperative KSS < 70, the medial compartment translation was almost one-fourth of the lateral one. Surgeons should be aware that an over-constrained kinematic of the medial compartment might lead to lower clinical outcomes. Level of evidence II.

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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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The Effects of Tourniquet Application in Total Knee Arthroplasty on the Recovery of Thigh Muscle Strength and Clinical Outcomes

The Journal of Knee Surgery ◽

10.1055/s-0040-1701454 ◽

2020 ◽

Cited By ~ 1

Author(s):

Omer Ayik ◽

Mehmet Demirel ◽

Fevzi Birisik ◽

Ali Ersen ◽

Halil I. Balci ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Muscle Strength ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Peak Torque ◽

Thigh Muscle ◽

Controlled Study ◽

Total Work ◽

Isokinetic Muscle Strength ◽

Total Knee

AbstractThe present randomized controlled study aims to evaluate whether tourniquet application during total knee arthroplasty (TKA) has an effect on (1) thigh muscle strength (quadriceps and hamstring muscle strength) and (2) clinical outcomes (postoperative knee range of motion [ROM], postoperative pain level, and Knee Society Score [KSS]). The effects of tourniquet application during TKA were investigated in 65 patients randomly allocated to one of two groups: TKA with a tourniquet and TKA without a tourniquet. Patients in both groups were comparable in terms of the demographic and clinical data (p > 0.05 for age, number of patients, sex, radiographic gonarthrosis grade, American Society of Anesthesiologists [ASA] classification, and body mass index [BMI]). All patients in both groups were operated by the same surgeon using one type of prosthesis. Isokinetic muscle strength (peak torque and total work) of knee extensors (quadriceps) and flexors (hamstrings) was measured in Newton meters (Nm) using a CYBEX 350 isokinetic dynamometer (HUMAC/CYBEX 2009, Stoughton, MA). The combined KSS (knee score + function score), visual analog scale (VAS), and knee ROM were measured preoperatively and at 1 and 3 months postoperatively to evaluate clinical outcomes. There were no significant differences between the two groups in preoperative and postoperative values of isokinetic muscle strength (peak torque and total work) and aforementioned clinical outcomes (p < 0.05). The present study has shown that quadriceps strength and clinical outcomes were not improved in the early postoperative period (3 months) when a tourniquet was not used during TKA.

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Accelerometer-Based Portable Navigation System Is Useful for Tibial Bone Cutting in Modified Kinematically Aligned Total Knee Arthroplasty

The Journal of Knee Surgery ◽

10.1055/s-0039-3402481 ◽

2019 ◽

Cited By ~ 1

Author(s):

Masanori Tsubosaka ◽

Tomoyuki Kamenaga ◽

Yuichi Kuroda ◽

Koji Takayama ◽

Shingo Hashimoto ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Navigation System ◽

Slope Angle ◽

Posterior Slope ◽

Tibial Bone ◽

Significant Difference ◽

Portable Navigation ◽

Total Knee

AbstractSeveral studies have reported better clinical outcomes following kinematically aligned total knee arthroplasty (KA-TKA) than mechanically aligned TKA. Consistent reproduction of a KA-TKA is aided by accurate tibial bone resections using computer navigation systems. This study compares an accelerometer-based portable navigation system with a conventional navigation system on tibial bone resection and clinical outcomes in KA-TKA. This study included 60 knees of patients who underwent primary KA-TKA between May 2015 and September 2017. They were randomly assigned to the OrthoPilot and iASSIST groups. A tibial bone cut was performed with 3 degree varus and 7 degree posterior slope in relation to the mechanical axis in all cases. The tibial component angle (TCA) and posterior slope angle (PSA) were evaluated by postoperative radiography, and those that deviated more than 2 degree were set as outliers. The clinical outcomes were the knee range of motion (ROM) and 2011 Knee Society Score (KSS) evaluated at 1 year postoperation. The groups were compared in terms of the TCA, PSA, number of outliers, ROM, and 2011 KSS (p < 0.05). No significant difference was observed between the groups in terms of the mean TCA, PSA, number of outliers, ROM, and categories of the 2011 KSS (objective knee indicators, symptoms, satisfaction, expectations, and functional activities). Although tibial bone cuts were performed with 3 degree varus and 7 degree posterior slope, no significant difference was observed between the OrthoPilot and iASSIST groups in terms of the accuracy of cuts or postoperative clinical result. The iASSIST was found to be a simple and useful navigation system for KA-TKA.

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