scholarly journals Effects of Sarcopenic Obesity and Its Confounders on Knee Range of Motion Outcome after Total Knee Replacement in Older Adults with Knee Osteoarthritis: A Retrospective Study

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3817
Author(s):  
Chun-De Liao ◽  
Shih-Wei Huang ◽  
Yu-Yun Huang ◽  
Che-Li Lin
Keyword(s):  
Older Adults ◽  
Body Composition ◽  
High Risk ◽  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Sarcopenic Obesity ◽  
Confounding Factors ◽  
Total Knee

Sarcopenic obesity is closely associated with knee osteoarthritis (KOA) and has high risk of total knee replacement (TKR). In addition, poor nutrition status may lead to sarcopenia and physical frailty in KOA and is negatively associated with surgery outcome after TKR. This study investigated the effects of sarcopenic obesity and its confounding factors on recovery in range of motion (ROM) after total knee replacement (TKR) in older adults with KOA. A total of 587 older adults, aged ≥60 years, who had a diagnosis of KOA and underwent TKR, were enrolled in this retrospective cohort study. Sarcopenia and obesity were defined based on cutoff values of appendicular mass index and body mass index for Asian people. Based on the sarcopenia and obesity definitions, patients were classified into three body-composition groups before TKR: sarcopenic-obese, obese, and non-obese. All patients were asked to attend postoperative outpatient follow-up admissions. Knee flexion ROM was measured before and after surgery. A ROM cutoff of 125 degrees was used to identify poor recovery post-surgery. Kaplan-Meier curve analysis was performed to measure the probability of poor ROM recovery among study groups. Cox multivariate regression models were established to calculate the hazard ratios (HRs) of postoperative poor ROM recovery, using potential confounding factors including age, sex, comorbidity, risk of malnutrition, preoperative ROM, and outpatient follow-up duration as covariates. Analyses results showed that patients in the obese and sarcopenic-obese groups had a higher probability of poor ROM recovery compared to the non-obese group (all p < 0.001). Among all body-composition groups, the sarcopenic-obese group yielded the highest risk of postoperative physical difficulty (adjusted HR = 1.63, p = 0.03), independent to the potential confounding factors. Sarcopenic obesity is likely at the high risk of poor ROM outcome following TKR in older individuals with KOA.

scholarly journals Unicondylar knee replacement versus total knee replacement for the treatment of medial knee osteoarthritis: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Meichao Deng ◽  
Yang Hu ◽  
Zhongzu Zhang ◽  
Hongjun Zhang ◽  
Yiming Qu ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Meta Analysis ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Knee Oa ◽  
Unicondylar Knee Replacement ◽  
Total Knee

Abstract Background Since the optimal surgery for isolated medial knee osteoarthritis (OA) is unclear, this study aimed at comparing the effectiveness of unicondylar knee replacement (UKR) with total knee replacement (TKR) for simple medial knee OA. Methods Literature searches of PubMed, Embase, Web of Science, and the Cochrane Library were searched up to 1th April 2020. Only studies comparing UKR with TKR for isolated medial knee OA were included. Data collection and extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Results A total of 13 articles with 1888 patients were included, among which, 944 and 944 underwent UKR and TKR, respectively. The analyzed postoperative outcomes were mostly within 5 years of follow-up. The meta-analysis showed that UKR improved knee general function (P < 0.00001) and health (P = 0.02), moreover, reduced post-operative pain (P = 0.01) and complications (P < 0.05) more than TKR. There were no significant differences in postoperative revision (P = 0.252), high-activity arthroplasty score (HAAS) (P = 0.307) and Oxford knee score (OKS) (P = 0.15) between the two techniques. Conclusions The patients of UKR could achieve better clinical results than that of TKR, moreover, there were negligible differences between the two techniques in postoperative revision in the early and mid-term follow-up and surgeons should be aware of the important reasons for revision of UKR. Thus, UKR instead of TKR should be performed in patients with late-stage isolated medial knee OA.

scholarly journals Impact of sarcopenia on rehabilitation outcomes after total knee replacement in older adults with knee osteoarthritis

2021 ◽  
Vol 13 ◽  
pp. 1759720X2199850
Author(s):  
Chun-De Liao ◽  
Hung-Chou Chen ◽  
Shih-Wei Huang ◽  
Tsan-Hon Liou
Keyword(s):  
Older Adults ◽  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Outcome Measures ◽  
Knee Replacement ◽  
Working Group ◽  
Womac Pain ◽  
Postoperative Rehabilitation ◽  
Rehabilitation Outcomes ◽  
Total Knee

Introduction: Knee osteoarthritis (KOA) is associated with an increased risk of sarcopenia, and aging-related muscle deterioration continues after total knee replacement (TKR). Low skeletal muscle mass index may influence postoperative rehabilitation outcomes. Through this study, we aimed to investigate the impact of preoperative sarcopenia on clinical outcomes after postoperative rehabilitation in older Asian adults. Methods: A total of 190 older adults (39 men, 151 women) were enrolled from two previous trials and were classified as having no sarcopenia, class I sarcopenia, or class II sarcopenia according to definitions provided by the Asian Working Group for Sarcopenia (AWGS) and the European Working Group on Sarcopenia in Older People (EWGSOP). All patients were retrospectively analyzed before (T0) and after (T1) TKR rehabilitation and 10 months after surgery (T2). The outcome measures included the timed up-and-go test (TUGT), gait speed (GS), timed chair rise (TCR), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and physical difficulty (WOMAC-PF). With patient characteristics and T0 scores as covariates, an analysis of variance was performed to identify intergroup differences in changes of all outcome measures at T1 and T2. Results: According to the definitions of both the AWGS and EWGSOP, patients with class I and class II sarcopenia exhibited minor changes in TUGT, GS, TCR, and WOMAC-PF at T1 and T2 (all p < 0.05), compared with those without sarcopenia. For patients classified as having sarcopenia based on AWGS and EWGSOP definitions, no significant intergroup differences in WOMAC pain score was observed at T1 or T2 (all p > 0.05). Conclusions: Sarcopenia independently had negative impacts on the treatment effects of rehabilitation on physical mobility but not on pain outcome after TKR in older adults with KOA.

Preoperative synovitis in knee osteoarthritis is predictive for pain 1 year after total knee arthroplasty

2017 ◽  
Vol 16 (1) ◽  
pp. 184-184
Author(s):  
Jonathan Vela ◽  
Kristian Kjær Petersen ◽  
Lars Arendt-Nielsen ◽  
Mikkel Meyer Andersen ◽  
Ole Simonsen
Keyword(s):  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Linear Regression Analysis ◽  
Point Scale ◽  
Post Surgery ◽  
Patient Reported ◽  
Total Knee ◽  
One Year

Abstract Background Knee osteoarthritis (KOA) was previously considered a degenerative joint disease due to wear and tear. After total Knee replacement (TKR) 13–38% of patients develop persistent post-operative pain. Emerging evidence has shown that the etiology of pain in KOA is multifaceted and may involve different structures including the synovial membrane, musculotendinous structures and neuronal tissue. Current preoperative assessment does not take these into account, thus the current study examines the role of preoperative synovitis on patient reported outcomes one-year post surgery. Material and methods 40 patients with end-stage KOA answered the KOOS questionnaire prior to receiving total knee replacement surgery. During the procedure synovitis was scored systematically at six sites where synovial excision biopsies were obtained. Macro scoring was based on three parameters (hypertrophy, vascularity and synovitis) on a 0–4 point scale. Micro biopsies where also graded based on three parameters (synovial hyperplasia, inflammatory infiltration and activation of synovial stroma) but on a 0–3 point scale. Patients received a follow up KOOS questionnaire one-year post surgery. Results 33 patients completed the KOOS questionnaire at follow-up. A high correlation between the micro mean, micro max, macro mean, and macro max was found. The micro mean was chosen as a proxy for the amount of synovitis. A multiple linear regression analysis, correcting for baseline values of BMI, age, smoking, point pressure thresholds (PPTs) and KOOS pain, showed that the synovitis measurement at baseline was significant for the change in KOOS pain with an effect of 22.22 (p = 0.0498). Hence, the more synovitis at baseline, the higher the follow-up KOOS Pain was compared to baseline KOOS Pain (an improvement). The standard deviation (SD) of the synovitis measure was 0.42, hence a change of 1 SD in synovitis gave an increase of 9 in KOOS Pain at follow-up compared to at baseline. Conclusions These preliminary results indicate that the synovitis score attained during operation is positively correlated with improvement in KOOS-pain post operatively.

Thalamic Neurometabolite Alterations in Patients with Knee Osteoarthritis Before and After Total Knee Replacement

2021 ◽  
Vol 22 (5) ◽  
pp. 601
Author(s):  
Akila Weerasekera ◽  
Erin Morrissey ◽  
Minhae Kim ◽  
Atreyi Saha ◽  
Yang Lin ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Before And After ◽  
Total Knee

Manipulation under anaesthesia post total knee replacement: Long term follow up

The Knee ◽  
2012 ◽  
Vol 19 (4) ◽  
pp. 329-331 ◽  
Author(s):  
David Yeoh ◽  
Nick Nicolaou ◽  
Richard Goddard ◽  
Henry Willmott ◽  
Kim Miles ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Long Term Follow Up ◽  
Manipulation Under Anaesthesia ◽  
Total Knee

scholarly journals Over 5-Year Follow-up of Total Knee Replacement with the Okayama University Type(Mark II).

1991 ◽  
Vol 40 (1) ◽  
pp. 55-58
Author(s):  
Eiji Kawaguchi ◽  
Tetuya Hirano ◽  
Kunihiko Tomoda ◽  
Kenichi Yamashiro ◽  
Kiminori Sakamoto ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Total Knee

scholarly journals High prevalence of vitamin D deficiency in elderly patients with advanced osteoarthritis scheduled for total knee replacement associated with poorer preoperative functional state

2013 ◽  
Vol 95 (8) ◽  
pp. 569-572 ◽  
Author(s):  
JA Jansen ◽  
FS Haddad
Keyword(s):  
Vitamin D ◽  
Total Knee Replacement ◽  
Elderly Patients ◽  
Knee Osteoarthritis ◽  
Vitamin D Deficiency ◽  
Knee Replacement ◽  
Functional State ◽  
High Prevalence ◽  
Outcome Scores ◽  
Total Knee

Vitamin D deficiency has been reported previously in patients with osteoarthritis undergoing total hip arthroplasty. We found a high prevalence of vitamin D deficiency in elderly patients with advanced knee osteoarthritis scheduled for total knee replacement and also a significant association with a lower preoperative functional state. A review of the literature is given on vitamin D deficiency in patients with knee osteoarthritis and the association with lower outcome scores after arthroplasty is discussed.

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