scholarly journals Intra- and inter-rater reliability of the Knee Society Knee Score when used by two physiotherapists in patients post total knee arthroplasty

2010 ◽  
Vol 66 (1) ◽  
Author(s):  
S. Gopal ◽  
W. Wood ◽  
H. Myezwa ◽  
A. Stewart

Background and Purpose: It has yet to be shown whether routine physiotherapy plays a role in the rehabilitation of patients post totalknee arthroplasty (Rajan et al 2004). Physiotherapists should be using validoutcome measures to provide evidence of the benefit of their intervention. The aim of this study was to establish the intra and inter-rater reliability of the Knee Society Knee Score, a scoring system developed by Insall et al(1989). The Knee Society Knee Score can be used to assess the integrity of theknee joint of patients undergoing total knee arthroplasty. Since the scoreinvolves clinical testing, the intra-rater reliability of the clinician should be established prior to using the scores as datain clinical research. W here multiple clinicians are involved, inter-rater reliability should also be established.Design: This was a correlation study.Subjects: A  sample of thirty patients post total knee arthroplasty attending the arthroplasty clinic at Johannesburg Hospital between six weeks and twelve months postoperatively.M ethod: Recruited patients were evaluated twice with a time interval of one hour between each assessment. Statistical A nalysis: The intra- and inter-rater reliability were estimated using Intraclass Correlation Coefficient (ICC). R esults: The intra-rater reliability showed excellent reliability (h= 0.95) for Examiner A  and good reliability (h= 0.71)for Examiner B. The inter-rater reliability showed moderate reliability (h= 0.67 during test one and h= 0.66 during test two).Conclusion: The KSKS has good intra-rater reliability when tested within a period of one hour. The KSKS demonstrated moderate agreement for inter rater reliability.

2018 ◽  
Vol 100-B (5) ◽  
pp. 579-583 ◽  
Author(s):  
S. Xu ◽  
J. Y. Chen ◽  
N. N. Lo ◽  
S. L. Chia ◽  
D. K. J. Tay ◽  
...  

AimsThis study investigated the influence of body mass index (BMI) on patients’ function and quality of life ten years after total knee arthroplasty (TKA).Patients and MethodsA total of 126 patients who underwent unilateral TKA in 2006 were prospectively included in this retrospective study. They were categorized into two groups based on BMI: < 30 kg/m2(control) and ≥ 30 kg/m2(obese). Functional outcome was assessed using the Knee Society Function Score (KSFS), Knee Society Knee Score (KSKS), and Oxford Knee Score (OKS). Quality of life was assessed using the Physical (PCS) and Mental Component Scores (MCS) of the 36-Item Short-Form Health Survey.ResultsPatients in the obese group underwent TKA at a younger age (mean, 63.0 years, sd 8.0) compared with the control group (mean, 65.6 years, sd 7.6; p = 0.03). Preoperatively, both groups had comparable functional and quality-of-life scores. Ten years postoperatively, the control group had significantly higher OKS and MCS compared with the obese group (OKS, mean 18 (sd 5) vs mean 22 (sd 10), p = 0.03; MCS, mean 56 (sd 10) vs mean 50 (sd 11), p = 0.01). After applying multiple linear regression with the various outcomes scores as dependent variables and age, gender, and Charlson Comorbidity Index as independent variables, there was a clear association between obesity and poorer outcome in KSFS, OKS, and MCS at ten years postoperatively (p < 0.01 in both KSFS and OKS, and p = 0.03 in MCS). Both groups had a high satisfaction rate (97.8% in the control group vs 87.9% in the obese group, p = 0.11) and fulfillment of expectations at ten years (98.9% in the control group vs 100% in the obese group, p = 0.32).ConclusionAlthough both obese and non-obese patients have significant improvements in function and quality of life postoperatively, obese patients tend to have smaller improvements in the OKS and MCS ten years postoperatively. It is important to counsel patients on the importance of weight management to achieve a more sustained outcome after TKA. Cite this article: Bone Joint J 2018;100-B:579–83.


2020 ◽  
pp. 2050020
Author(s):  
Xabier Foruria ◽  
Jesús Moreta ◽  
Carlos Jaramillo ◽  
Ane Anton ◽  
Isidoro Calvo ◽  
...  

Objective: Patient-specific positioning guides have been designed to improve precision in total knee arthroplasty. The aim of this study is to evaluate the medium-term clinical and radiological outcomes with magnetic resonance imaging-based patient-specific positioning guides. Material and methods: We retrospectively reviewed patients from two centers treated with total knee arthroplasty performed with patient-specific positioning guides. We enrolled patients operated on between January 2011 and December 2013, with a minimum follow-up of 5 years. Preoperative and postoperative hip knee angle (HKA) and position of each component in the coronal plane were assessed. Overall malalignment was defined as an outlier of more than [Formula: see text] from the neutral mechanical axis and specific malalignment as when any component showed more than [Formula: see text] of deviation. Clinical outcomes were evaluated using the Hospital for Special Surgery (HSS) knee Score. Results: This study included 68 patients with a mean age of 72 years. The mean postoperative alignment (HKA) was [Formula: see text] and 26.5% of patients showed coronal malalignment [Formula: see text]. Regarding femoral components, 19.1% showed specific malalignment [Formula: see text], while 11.7% of tibial components were classified as outliers. The mean HSS Knee Score at final follow up was 89.2. Patients whose implants were mechanically aligned did not obtain better functional outcomes ([Formula: see text]). Conclusion: In our series, the use of patient-specific positioning guides resulted in a range of mechanical malalignment, similar to conventional instrumentation results reported in the literature.


2020 ◽  
Vol 34 (01) ◽  
pp. 115-120
Author(s):  
Ali Utkan ◽  
Emrah Caliskan ◽  
Batuhan Gencer ◽  
Bulent Ozkurt

AbstractAlthough there are numerous studies about routine histopathological analysis during arthroplasty surgeries, most of them showed that new diagnoses have rarely been obtained as a result. The aim of this study was to evaluate the efficacy of routine pathological analyses of synovia resected during primary total knee arthroplasty in patients with osteoarthritis and its relevance in the treatment process. Of the 47 included patients who were followed up prospectively, 26 patients had clinical and histopathological concordant diagnoses and 21 patients had discrepant diagnoses. Oxford knee score and visual analogue score were performed for all the patients. Kallgren-Lawrence score was used for radiological analyses. The Mann-Whitney U test was used to examine the differences between the abnormally distributed variables. Mean age was 65.9 ± 4.3 years (range, 50–89 years) and mean follow-up time was 19 ± 7.8 months (range, 6–39 months). Grade IV gonarthrosis was found to be statistically lower in the discrepant group (p = 0.046). The mean preoperative Oxford knee score was 16.8 ± 2.3 (range, 2–23) and the mean postoperative Oxford knee score was 44.6 ± 1.8 (range, 27–48; p = 0.016). Postoperative Oxford knee scores and VAS were significantly increased in both the concordant and discrepant groups (p = 0.026 and p = 0.035, p = 0.019 and p = 0.039, respectively). Resection and histopathologic analyses of the hypertrophied and inflamed synovium encountered during primary arthroplasty procedure should be performed. This examination not only could provide crucial information that may influence the postoperative follow-up guidelines but also could help us to expand our knowledge and awareness of rare diseases that might yield osteoarthritis. The level of evidence for the study is level II.


2012 ◽  
Vol 471 (2) ◽  
pp. 600-605 ◽  
Author(s):  
Il Soo Eun ◽  
Ok Gul Kim ◽  
Chang Kyu Kim ◽  
Hong Seok Lee ◽  
Jung Sub Lee

Author(s):  
B Mital Shah ◽  
A Thangamani Ramalingam ◽  
D Bid Dibyendunarayan ◽  
Patel KeniK ◽  
S Patel Krishna ◽  
...  

2015 ◽  
Vol 95 (10) ◽  
pp. 1397-1407 ◽  
Author(s):  
Andy C.M. Chan ◽  
Marco Y.C. Pang

BackgroundThe Balance Evaluation Systems Test (BESTest) is a relatively new balance assessment tool. Recently, the Mini-BESTest and the Brief-BESTest, which are shortened versions of the BESTest, were developed.ObjectiveThe purpose of this study was to estimate interrater and intrarater-interoccasion reliability, internal consistency, concurrent and convergent validity, and floor and ceiling effects of the 3 BESTests and other related measures, namely, the Berg Balance Scale (BBS), Functional Gait Assessment (FGA), and Activities-specific Balance Confidence (ABC) Scale, among patients with total knee arthroplasty (TKA).DesignThis was an observational measurement study.MethodsTo establish interrater reliability, the 3 BESTests were administered by 3 independent raters to 25 participants with TKA. Intrarater-interoccasion reliability was evaluated in 46 participants with TKA (including the 25 individuals who participated in the interrater reliability experiments) by repeating the 3 BESTests, BBS, and FGA within 1 week by the same rater. Internal consistency of each test also was assessed with Cronbach alpha. Validity was assessed in another 46 patients with TKA by correlating the 3 BESTests with BBS, FGA, and ABC. The floor and ceiling effects also were examined.ResultsThe 3 BESTests demonstrated excellent interrater reliability (intraclass correlation coefficient [ICC] [2,1]=.96–.99), intrarater-interoccasion reliability (ICC [2,1]=.92–.96), and internal consistency (Cronbach alpha=.96–.98). These values were comparable to those for the BBS and FGA. The 3 BESTests also showed moderate-to-strong correlations with the BBS, FGA, and ABC (r=.35–.81), thus demonstrating good concurrent and convergent validity. No significant floor and ceiling effects were observed, except for the BBS.LimitationsThe results are generalizable only to patients with TKA due to end-stage knee osteoarthritis.ConclusionsThe 3 BESTests have good reliability and validity for evaluating balance in people with TKA. The Brief-BESTest is the least time-consuming and may be more useful clinically.


2015 ◽  
Vol 27 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Jin Kyu Lee ◽  
Ji-Hoon Shim ◽  
Kyu-Sung Chung ◽  
Choong Hyeok Choi

Background: Osteoarthritis involves degeneration of articular cartilage seen with increasing age. The knee joint, the most common joint that falls prey to attacks of osteoarthritis, has 30% incidence in population above 60 years. Total knee arthroplasty (TKA) is the main surgical option for orthopaedics. Though it corrects the deformity and relieves pain, yet it is not the treatment of choice in younger population. This study aimed to validate the effects of proximal fibular osteotomy (PFO) as a newer technique in managing medial compartment knee osteoarthritis. Methods: The diagnosed patients for medial compartment knee joint osteoarthritis were selected for study from Dr. Ziauddin University hospital of Karachi. Excluded were aged less than 40 years, or with BMI more than 30, and patients with tri-compartmental arthritis. Medial and lateral joint spaces along with Oxford knee score were measured and recorded pre- and post-operatively. Patients underwent PFO after giving written and informed consent. Results: Total number of patients selected was 30 for this study; 21 (70%) females, and 9 (30%) males (mean age 58.8 years). Mean pre-operative measured medial joint space on standard antero-posterior (AP) radiograph was 0.442± 0.04 cm. Mean recorded pre-operative Oxford knee score was 23.87±3.74 mm. Improvement was observed in mean postoperative medial joint space to 0.572± 0 .066 cm and mean post-operative Oxford knee score to 40.2±5.8mm. Conclusion: This study concludes that PFO significantly improves joint function in patients with medial compartment osteoarthritis knee and may delay the need for total knee arthroplasty, if carried out at an appropriate stage. Keywords: Osteotomy; Osteoarthritis; Total Knee Arthroplasty.


Arthroplasty ◽  
2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Gaurav Govil ◽  
Lavindra Tomar ◽  
Pawan Dhawan

Abstract Peri-prosthetic patella fracture is the second most common peri-prosthetic fracture after total knee arthroplasty. This report presented the treatment results in 6 patients with peri-prosthetic patella fractures. From January 2015 to February 2019, six patients with peri-prosthetic patella fractures were treated. The mean age at surgery was 64 years (range, 48–72 years). Four patients with displaced fractures were treated surgically, and two patients with non-displaced fractures were treated non-surgically. Outcomes were assessed in terms of motion, functional knee score, and Knee Society score. The mean follow-up period lasted 16 months (range: 12–20 months). The average arc of motion was 110° (range: 80°–130°). The mean functional knee score was 77 (range: 70–87). The mean Knee Society score was 84 (range: 75–89). The non-surgical treatment may be a good choice for non-displaced peri-prosthetic patella fractures. For displaced fractures, surgical treatments yielded good functional outcomes. Level of evidence IVa


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