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1.
Mymensingh Med J ; 31(1): 165-171, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34999698

RESUMO

Osteoarthritis (OA) is a chronic, progressive disease involving the degeneration of cartilage and joint tissue, resulting in pain and disability. Bilateral total knee arthroplasty (TKA) is is an effective intervention that improves quality of life, reduces pain and increases functional capability. This study was performed to compare the functional outcomes between staged and simultaneous total knee arthroplasty. This prospective interventional study was carried out in Arthroscopic and Arthroplasty unit of BSMMU, Dhaka from January 2017 to December 2018. A total of 60 OA patients underwent TKA were included in this study. Thirty patients underwent simultaneous TKA procedure and 30 patients underwent staged TKA procedures performed with 1-6 months between stages were included. Pre-operative and post operative data were collected. Data were analyzed using SPSS 12.0. Numerical data were analyzed using unpaired t test and categorical data were analyzed using Chi-Square test. A value of p<0.05 was considered statistically significant. Mean age of the study subjects was 60.47±10.13 years in staged group and 59.30±9.90 years in simultaneous group. Male to female ratio was 1:1.5 in staged group and 1:2 in simultaneous group. Mean BMI of the study subjects was 30.70±4.91kg/m² in staged group and 30.06±4.79kg/m² in simultaneous group (p>0.05). In both groups, maximum study subjects were housewife (33.3% vs. 33.3%). In staged group 13.3% and 16.7% in simultaneous group were heavy worker; 20.0% in staged group and 16.7% in simultaneous group were medium worker (p>0.05). Pain, motion, stability and function were significantly changed after surgery comparing before surgery.Infection was observed in 10.0% cases in both groups. Stiffness was observed in 10.0% cases in staged group but in 6.7% cases in simultaneous group. Even final outcome showed better in simultaneous procedure, there was no significant difference between two procedures. The outcome of both simultaneous andstaged procedure of bilateral total knee replacement in Advanced Osteoarthritis is similar.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Idoso , Bangladesh , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/cirurgia , Estudos Prospectivos , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento
2.
BMC Musculoskelet Disord ; 23(1): 45, 2022 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-35027035

RESUMO

OBJECTIVE: To evaluate the impact of body mass index (BMI) on the mid-term clinical outcomes and survival in patients receiving a mobile-bearing unicompartmental knee arthroplasty (UKA). METHODS: We retrospectively collected data from 355 patients who underwent UKA from June 2006 to June 2015, with a mean follow-up of 106.5 ± 22.5 months. Patients were assigned into four groups based on their BMI before surgery: normal weight group (BMI 18.5 ~ 22.9 kg/m2), overweight group (23 ~ 24.9 kg/m2), obesity group (25 ~ 29.9 kg/m2), and severe obesity group (≥ 30 kg/m2). The knee society score (KSS), knee society function score (KSFS), hospital for special surgery score (HSS), and range of motion (ROM) were assessed before the operation and at the last follow-up. The femorotibial angle (FTA) was assessed after the operation immediately and at the last follow-up. Kaplan-Meier survival analysis was performed among the four groups. RESULTS: The KSS, KSFS, and HSS in all groups were markedly improved compared with the preoperative values (p<0.001), but the ROM score was not significantly different (p>0.05). There were significant differences in KSS (p<0.001) and HSS (p = 0.004) across the four BMI groups, and these differences were due to the severe obesity group. All groups exhibited an inclination of knee varus deformity at the last follow-up (p < 0.05). Moreover, no marked difference in the implant survival rate was found among the different groups (p = 0.248), or in the survival curves (p = 0.593). CONCLUSIONS: BMI does not influence the implant survival rate. The postoperative functional and quality-of-life scores were significantly improved in all groups. Obese (BMI ≥30 kg/m2) individuals should not be excluded from UKA.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Artroplastia do Joelho/efeitos adversos , Índice de Massa Corporal , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/cirurgia , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento
3.
Zhonghua Yi Xue Za Zhi ; 102(1): 56-61, 2022 Jan 04.
Artigo em Chinês | MEDLINE | ID: mdl-34991238

RESUMO

Objective: To explore the differences of alignment and position of prosthesis between portable accelerometer-based navigation device (PAD) and conventional instrumentation (CI) in total knee arthroplasty (TKA) with valgus deformity. Methods: Patients with knee osteoarthritis and valgus deformity who underwent primary TKA in Peking University Third Hospital from January 2017 to December 2020 were enrolled in this retrospective study and were divided into PAD group and CI group according to the surgical instruments. Five male patients and 44 female patients were included with a mean age of (67.2±7.0) years. The differences in preoperative general data, preoperative and postoperative alignment between the two groups were studied. Results: A total of 49 patients (25 patients in the PAD group and 24 in the CI group) were enrolled in this study. There were no statistically significant differences in gender, age, height, weight, body mass index, surgical side, preoperative hip-knee-ankle (HKA) angle, preoperative HKA angle deviation, Keblish classification and Ranawat classification between the two groups (all P>0.05). There was no significant difference in the accuracy of postoperative HKA angle (2.0°±1.4° vs 3.0°±2.2°, P=0.082), coronal femoral component angle (CFCA) (1.5°±1.2° vs 2.1°±1.6°, P=0.144) and coronal tibial component angle (CTCA) (1.2°±0.8° vs 1.3°±1.0°, P=0.695) between the two groups; but the standard deviation of the above-mentioned three indices in PAD group were all smaller than those in CI group. The rate of outliers of postoperative HKA angle of the PAD group was smaller than that in the CI group (P<0.05), but there was no significant difference in the rate of outliers of CFCA and CTCA between the two groups (both P>0.05). Conclusion: TKA assisted by PAD can provide good alignment and prosthesis position in patients with valgus deformity, and it is superior to TKA with CI in terms of precision and rate of outliers of postoperative overall alignment of lower extremity.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Acelerometria , Idoso , Feminino , Humanos , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/cirurgia , Próteses e Implantes , Estudos Retrospectivos
4.
BMC Musculoskelet Disord ; 23(1): 32, 2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-34983471

RESUMO

BACKGROUND: This study aimed to evaluate the efficacy of viscosupplementation after arthroscopic partial meniscectomy. METHOD: A randomized controlled trial of 47 patients who underwent arthroscopic partial meniscectomy was conducted between March 2020 and March 2021. Patients were randomized into two groups: a viscosupplementation group (n = 23) and a control group (n = 24). A single-dose intraarticular hyaluronic acid injection was used as viscosupplementation. The 100 mm visual analogue scale (VAS) for pain assessment was measured at baseline and at 1 day, 2 weeks, 6 weeks, and 3 months post-surgery. The International Knee Documentation Committee (IKDC), Tegner, Lysholm, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores and range of motion (ROM) of the knee were measured at baseline, 2 weeks, 6 weeks, and 3 months. RESULTS: The 100 mm VAS score for pain was significantly lower in the viscosupplementation group at 2 weeks post-surgery (27.5 mm vs. 40.7 mm, P = 0.047). ROM was significantly greater in the viscosupplementation group than in the control group at 2 weeks (131.5° vs. 121.0°, P = 0.044) post-surgery. No significant differences were observed in the IKDC or in the Tegner, Lysholm, and WOMAC scores between the two groups. CONCLUSIONS: Viscosupplementation after arthroscopic partial meniscectomy significantly reduced pain at 2 weeks post-surgery and improved ROM of the knee at 2 weeks post-surgery. There might be some benefits in terms of pain and functional recovery of viscosupplementation after arthroscopic surgery. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. TRIAL REGISTRATION: This randomized controlled trial was registered at cris.nih.go.kr # KCT0004921 .


Assuntos
Osteoartrite do Joelho , Viscossuplementação , Artroscopia , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Meniscectomia/efeitos adversos , Osteoartrite do Joelho/tratamento farmacológico , Osteoartrite do Joelho/cirurgia , Resultado do Tratamento
5.
BMC Musculoskelet Disord ; 23(1): 55, 2022 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-35039019

RESUMO

BACKGROUND: There is an existing perception that obesity has a negative impact on complications following total knee arthroplasty (TKA). However, data on the impact of obesity levels on patient-reported outcomes (PROMs) is sparse. We investigated the association between different obesity classes with PROMs among patients who underwent TKA. METHODS: We performed retrospective secondary analyses on data extracted from the total joint replacement data repository (Alberta, Canada) managed by the Alberta Bone and Joint Health Institute (ABJHI). Patients had WOMAC and EQ5D scores measured at baseline in addition to 3 and/or 12 months following TKA. Patients were stratified according to the World Health Organization (WHO) classification, into five body mass index (BMI) groups of normal, overweight, BMI class I, BMI class II, and BMI class III. The association between BMI and mean changes in WOMAC subscales (pain, function, and stiffness) and EQ-5D-5L index over the time intervals of baseline to 3 months and 3 to 12 months following TKA was assessed. Linear mixed-effects models were used, and the models were adjusted for age, sex, length of surgery, comorbidities, year of surgery, and geographical zone where the surgery was performed. RESULTS: Mean age was 65.5 years (SD = 8.7). Postoperatively, there was a significant improvement (p < 0.001) in WOMAC subscales of patient-reported pain, function, and stiffness, as well as EQ-5D-5L regardless of BMI group. Although, patients in BMI class II and class III reported significantly improved pain 3 months after TKA compared to those with normal BMI, all BMI groups attained similar level of pain reduction at 12 months after TKA. The greatest improvement in all WOMAC subscales, as well as EQ5D index, occurred between baseline and 3 months (adjusted p < 0.0001). CONCLUSION: The findings indicate that patients reported improved pain, function, and stiffness across all BMI groups following TKA. Patients with BMI classified as obese reported similar benefits to those with BMI classified as normal weight. These results may help health care providers to discuss expectations regarding the TKA recovery in terms of pain, function, and quality of life improvements with their TKA candidates.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Idoso , Alberta/epidemiologia , Artroplastia do Joelho/efeitos adversos , Humanos , Obesidade/diagnóstico , Obesidade/epidemiologia , Obesidade/cirurgia , Osteoartrite do Joelho/cirurgia , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento
6.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 36(1): 58-64, 2022 Jan 15.
Artigo em Chinês | MEDLINE | ID: mdl-35038800

RESUMO

Objective: To explore the prediction of postoperative coronal lower limb alignment by the tibia fibular angle (TFA) and femoral fibular angle (FFA) after osteotomy in medial open-wedge high tibial osteotomy (MOWHTO). Methods: A clinical data of 20 patients with medial compartment osteoarthritis, who were treated with MOWHTO between September 2019 and September 2020, was retrospectively analyzed. Among them, there were 9 males and 11 females; the age ranged from 46 to 69 years, with an average of 56.0 years. The body mass index (BMI) was 21.3- 35.7 kg/m 2, with an average of 26.7 kg/m 2. Osteoarthritis involved 11 cases of left knee and 9 cases of right knee; the disease duration was 2-6 years, with an average of 3.8 years. According to the Kellgren-Lawrence classification, there were 7 cases of grade Ⅰ, 9 cases of grade Ⅱ, and 4 cases of grade Ⅲ. The angle and height for open-wedge was planned preoperatively by osteotomy master software, and the TFA and FFA were measured by software after simulated osteotomy. The intraoperative angle for open-wedge was adjusted according to TFA and FFA after simulated osteotomy.The lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), mechanical femorotibial angle (mFTA), weight-bearing line (WBL) ratio, TFA, and FFA were measured before operation and at 2 days after operation. The difference (X) between the intraoperative measurement value and the preoperative plan value of TFA/FFA, and the difference (Y) between the postoperative WBL ratio and the target alignment (62.5%) were calculated, and the correlation between the two indicators was analyzed by Pearson's test. According to the median BMI of patients (25.81 kg/m 2), the patients were allocated into high BMI group (>25.81 kg/m 2, n=10) and low BMI group (≤25.81 kg/m 2, n=10), and the influencing factors of WBL ratio was analyzed by linear regression. Results: There was no significant difference between pre- and post-operation in LDFA and JLCA ( P>0.05); while there were significant differences between pre- and post-operation in MPTA, mFTA, and WBL ratio ( P<0.05). The TFA was (89.5±4.0)° during operation and (87.7±4.7)° after operation, showing significant difference ( t=2.991, P=0.008). There was a positive correlation between the difference (X) between the intraoperative measurement value and the preoperative plan value of TFA and the difference (Y) between the postoperative WBL ratio and the target alignment ( r=0.595, P=0.006). The FFA was (86.9±4.3)° during operation and (85.7±4.4)° after operation, showing significant difference ( t=1.760, P=0.094). There was a positive correlation between the difference (X) between the intraoperative measurement value and the preoperative plan value of FFA and the difference (Y) between the postoperative WBL ratio and the target alignment ( r=0.536, P=0.015). After BMI stratification, X was an influential factor of Y in the low BMI group ( P<0.05), but X was not an influential factor of Y in the high BMI group ( P>0.05). Conclusion: Intraoperative FFA and TFA can predict coronal limb alignment after MOWHTO. FFA and TFA can predict more preciselyfor patients with BMI≤25.81 kg/m 2.


Assuntos
Osteoartrite do Joelho , Tíbia , Idoso , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Extremidade Inferior/diagnóstico por imagem , Extremidade Inferior/cirurgia , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/cirurgia , Osteotomia , Estudos Retrospectivos , Tíbia/diagnóstico por imagem , Tíbia/cirurgia
7.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 36(1): 111-116, 2022 Jan 15.
Artigo em Chinês | MEDLINE | ID: mdl-35038808

RESUMO

Objective: To review the research progress of surgical methods of osteotomy around the knee in the treatment of valgus knee osteoarthritis. Methods: The relevant literature on the surgical treatment of valgus knee osteoarthritis at home and abroad in recent years was reviewed, and the advantages, disadvantages, and effectiveness of different surgical methods of osteotomy around the knee were summarized. Results: For young and active patients with symptomatic valgus knee osteoarthritis, osteotomy around the knee is a safe and reliable treatment option. At present, the main surgical methods include medial closing wedge distal femoral osteotomy, lateral opening wedge distal femoral osteotomy, medial closing wedge high tibial osteotomy, and lateral opening wedge high tibial osteotomy. The indications, advantages, and disadvantages of different osteotomies are different, and the selection of appropriate surgical method is the key to achieve good effectiveness. Conclusion: There are many osteotomies in the treatment of valgus knee osteoarthritis. In order to achieve good results, improve survival rate, and reduce postoperative complications, the most reasonable surgical strategy needs to be developed according to different situations.


Assuntos
Osteoartrite do Joelho , Humanos , Joelho , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Osteotomia , Tíbia , Resultado do Tratamento
8.
Comput Methods Programs Biomed ; 213: 106502, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34749244

RESUMO

PURPOSE: High tibial osteotomy (HTO) is an effective surgical treatment for varus knee osteoarthritis. However, obese patients require reinforced internal fixation materials to prevent internal fixation fractures and hardware failure after osteotomy. Therefore, the purpose of our study is to evaluate the clinical efficacy of distal tibial tuberosity high tibial osteotomy (DTT-HTO) using the new patented π-shaped plate in obese patients with varus knee osteoarthritis. METHOD: Thirty-four obese patients (39 knees) with varus knee osteoarthritis who underwent DTT-HTO with the π-shaped plate and second-look arthroscopy when implant removal occurred from September 2017 to June 2020 were retrospectively reviewed. Three-dimensional surgical planning using DTT-HTO on the knees is performed. There were 9 males and 25 females, with body mass index (BMI) values ranging from 30.3 to 38.5 kg/m2 and ages ranging from 50 to 75 years old. The radiological assessment was performed with the femora tibial angle (FTA) and the weight-bearing line ratio (WBLR). The clinical outcomes were evaluated by the Hospital for Special Surgery (HSS) knee score and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The status of the cartilage was evaluated by the International Cartilage Repair Society (ICRS) grading system. RESULTS: All patients were followed up for 18-30 months. The FTA significantly changed from 181.68±1.68.preoperatively to171.29±1.51.at the last follow-up (P<0.001). The WBLR significantly increased from 16.85±2.20 to 55.41±2.46% from before surgery to the last follow-up after surgery (P<0.001). The HSS score significantly improved from 56.65±5.27 preoperatively to 68.79±2.61, 77.82±2.15, and 86.12±2.78 at the 6-month, 12-month, and last follow-up after surgery (P<0.001). The WOMAC score significantly decreased from 105.47±3.89 preoperatively to 80.50±4.20, 71.44±4.65, and 52.44±3.14 at the 6-month, 12-month, and last follow-up after surgery (P<0.001). During implant removal, no internal fixation fractures occurred in any patient. The articular cartilage grade in the medial compartment of the knee were significantly higher in the second arthroscopy than in the first arthroscopy, according to the ICRS grading system (P<0.001). The articular cartilage grade in the lateral compartment of the knee showed no statistical differences from the first- to the second-look arthroscopy (P>0.05). CONCLUSION: There are no correlation between BMI and postoperative outcomes. DTT-HTO shows yield excellent clinical results in obese patients with varus knee osteoarthritis. It can be recommended to be used for the heavy patients.


Assuntos
Osteoartrite do Joelho , Idoso , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/cirurgia , Osteotomia , Estudos Retrospectivos , Tíbia/diagnóstico por imagem , Tíbia/cirurgia , Resultado do Tratamento
9.
J Orthop Traumatol ; 22(1): 53, 2021 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-34905126

RESUMO

BACKGROUND: High tibial osteotomy (HTO) provides reliable and good long-term results, if performed with correct indications, but different techniques and types of fixation have been described. The purpose of this study is to present a novel modified biplanar medial opening-wedge (MOW) HTO technique where the osteotomies are performed in a Z-shaped fashion, and to present the medium-term clinical and radiographic results. MATERIALS AND METHODS: We present a case series of 75 patients (80 knees) with mean age of 45.8 years, affected by isolated medial knee osteoarthritis and symptomatic varus knee malalignment, who underwent novel biplanar Z-shaped MOWHTO. Clinical and radiological outcomes were collected, retrospectively before surgery and at median follow-up of 7.2 years (95% CI 5.6-9.2 months) after surgery. Clinical results and satisfaction were assessed by visual analog scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and Likert scale. Radiological assessment involved the evaluation of the medial proximal tibial angle (MPTA), tibial slope (TS), Caton-Deschamps index, and knee osteoarthritis grade according to Ahlbäck classification. Pre- and postoperative results were compared using the two-tailed t-test or Wilcoxon's test of independent samples for paired data or nonparametric analog. P < 0.05 was considered significant. RESULTS: At medium-term follow-up, Z-shaped MOWHTO showed a survival rate of 95 ± 1.7% with failure occurring in four knees due to symptom recurrence and osteoarthritis progression. No perioperative complications were observed (intraarticular fracture, delayed union or nonunion, and neurological injury). Mean bone healing time was 12 weeks. Clinical scores showed significant improvement at last follow-up and a good grade of satisfaction. MPTA increased significantly, while Caton-Deschamps index decreased significantly. No significant TS increase was found. CONCLUSIONS: Modified biplanar Z-shaped MOWHTO is a safe and reliable technique that offers satisfactory clinical and radiological medium-term outcomes with low knee arthroplasty conversion rate. The unique three-dimensional geometrical conformation potentially provides a favorable environment for bone healing, increased anteroposterior and rotational stability, and safer opening-wedge loading force application with low lateral hinge fracture risk. LEVEL OF EVIDENCE: Level IV, retrospective observational case series study. Trial registration The study protocol was approved by the Internal Review Board of our Institution (authorization number 54/2019, 20 November 2019).


Assuntos
Articulação do Joelho , Osteoartrite do Joelho , Seguimentos , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/cirurgia , Osteotomia , Estudos Retrospectivos , Tíbia/diagnóstico por imagem , Tíbia/cirurgia
10.
Zhonghua Yi Xue Za Zhi ; 101(47): 3850-3856, 2021 Dec 21.
Artigo em Chinês | MEDLINE | ID: mdl-34905884

RESUMO

Objective: To explore the differences of alignment and operative time between computer assisted surgery (CAS) and personal specific instrumentation (PSI) in total knee arthroplasty (TKA). Methods: Patients with knee osteoarthritis who underwent unilateral primary TKA in Peking University Third Hospital from June 2019 to April 2021 were enrolled in this prospective study and were randomly divided into CAS group and PSI group with random number table. The differences in preoperative general data, operative time, preoperative and postoperative alignment between the two groups were studied. Results: A total of 80 patients were enrolled in this study, including 40 patients in the CAS group with an average age of (68±6) years (male/female, 6/34 cases) and 40 patients in the PSI group with an average age of (69±6) years (male/female, 5/35 cases). There was no significant differences in gender, age, height, weight, body mass index, surgical side, preoperative hip-knee-ankle (HKA) angle, and preoperative HKA angle deviation between the two groups (all P>0.05). The accuracy of sagittal femoral component angle (sFCA) (1.7°±1.2° vs 2.5°±1.4°, P<0.05) and sagittal tibial component angle (sTCA) (1.2°±0.9° vs 2.3°±1.8°, P<0.01) of the CAS group were both smaller than those in the PSI group, but there was no significant difference in the accuracy of postoperative HKA angle, mechanical lateral distal femoral angle (mLDFA) and mechanical medial proximal tibia angle (mMPTA) between the two groups (all P>0.05). The precision of postoperative HKA angle and sTCA of the CAS group were both smaller than those in the PSI group (2.0°±1.0° vs 2.6°±1.7°, 1.2°±0.9° vs 2.3°±1.8°, both P<0.01), but there was no significant differences in the precision of mLDFA, mMPTA and sFCA between the two groups (all P>0.05). The rate of outliers of postoperative HKA angle (10.0% vs 27.5%, P<0.05), sFCA(5.0% vs 20.0%, P<0.05) and sTCA (2.5% vs 22.5%, P<0.01) of the CAS group were all smaller than those in the PSI group, but there was no significant difference in the rate of outliers of mLDFA and mMPTA between the two groups (both P>0.05). CAS group had significantly longer surgical time than the PSI group ((81±12) min vs (52±8) min, P<0.01). Conclusions: CAS is better than PSI in overall coronal alignment and sagittal position of the prosthesis after TKA. However, CAS requires a longer operation time.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Cirurgia Assistida por Computador , Idoso , Feminino , Humanos , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/cirurgia , Estudos Prospectivos , Estudos Retrospectivos
11.
Pain Res Manag ; 2021: 8609921, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34900072

RESUMO

Background: High tibial osteotomy (HTO) is used to treat medial degeneration of the osteoarthritis (OA) knee. However, shortcomings still exist in the current procedure, like unprecise creation, inability to correct knee rotation, and internal fixed failure. Here, we reported a novel procedure: patient-specific 3D-printed plates for opening wedge high tibial osteotomy (OWHTO) combined with Taylor spatial frame (TSF). The detailed technique was described, and the clinical outcomes were evaluated. Methods: We prospectively evaluate outcomes of patient-specific 3D-printed plates for OWHTO with use of TSF in 25 patients with knee OA and varus alignment. Postoperative efficacy was evaluated using the HSS knee score, pain visual simulation score (VAS), and knee joint motion (ROM), and lower limb alignment was evaluated by measuring femorotibial angle (FTA) and hip-knee-ankle (HKA). Results and Conclusion. All patients did not experience complications such as wound infection, nerve damage, or bone amputation. 25 patients were followed up for 6-18 months. The bony union at bone amputation was achieved in 3 months after surgery, and the pain symptoms were significantly alleviated or disappeared. The VAS score was significantly reduced in 6 months after surgery compared with preoperative; the HSSS score was significantly added in 6 months after surgery compared with preoperative. The ROM of knee joint increased significantly 6 months after operation compared with that before operation, and the difference was statically significant (P < 0.05). The FTA and HKA after operation were significantly superior to that before operation, and the difference was statically significant (P < 0.01). Conclusions: Our study showed that patient-specific 3D-printed plates for HTO with the use of TSF have the advantages of small trauma, few complications, simple operation, and fast recovery in treating knee OA and varus alignment.


Assuntos
Osteoartrite do Joelho , Humanos , Articulação do Joelho , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/cirurgia , Osteotomia , Impressão Tridimensional , Estudos Retrospectivos , Tíbia/cirurgia
12.
Acta Orthop Traumatol Turc ; 55(6): 508-512, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34967739

RESUMO

OBJECTIVE: The aim of this study was to investigate the impact of preoperative patellofemoral osteoarthritis severity on the final patient-reported outcomes in patients with primary osteoarthritis who underwent total knee arthroplasty with patellar retention. METHODS: In this retrospective study, 167 patients (42 males, 125 females; mean age: 67.9 (range, 50-82) years), who underwent total knee arthroplasty with patellar retention due to primary osteoarthritis were included. The preoperative severity of patellofemoral osteoarthritis was classified according to the Iwano classification system. All the patients were then divided into two groups based on the severity of patellofemoral osteoarthritis: Group I, 73 patients (17 males, 56 females; mean age: 68.4 (range, 50-80) years) with mild osteoarthritis (stage 0-I) and group II, 94 patients (25 males, 69 females; mean age: 67.7 (range, 54-82) years) with moderate to severe osteoarthritis (stage II to IV). The mean follow-up was 42.8 (range, 24-59) months in group I and 41.7 (range, 24-63) months in group II. Clinical outcomes were assessed using the Oxford Knee Score, the New Knee Society Score-function score, and the Kujala score preoperatively and at the final follow-up. Also, the Forgotten Joint Score was performed at the final follow-up. RESULTS: The Oxford Knee Score improved from 22.5 (range, 18-26) preoperatively to 36.5 (range, 30-43) for Group I and from 21.9 (range, 16-25) preoperatively to 35.9 (range, 29-43) for Group II (P < 0.001). The Kujala score increased from 51.2 (range, 45- 65) preoperatively to 79.3 (range, 71-88) for Group I and from 50.3 (range, 42-60) preoperatively to 80.2 (range, 71-86) for Group II (P < 0.001). The New Knee Society Score-function score raised from 60.2 (range, 50-72) preoperatively to 82.2 (range, 72- 90) for Group I and from 59.5 (range, 48-69) preoperatively to 81.4 (range, 73-90) for Group II (P < 0.001). The Forgotten Joint Score was 69.9 (range, 63-76) in Group I and 70.2 (range, 62-77) in Group II (P = 0.49). CONCLUSION: Evidence from this study has shown that the preoperative severity of patellofemoral osteoarthritis has no significant impact on the final patient-reported outcomes of patients with primary osteoarthritis after patellar retention total knee arthroplasty. LEVEL OF EVIDENCE: Level III, Therapeutic Study.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Articulação Patelofemoral , Idoso , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Masculino , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/cirurgia , Patela/cirurgia , Articulação Patelofemoral/diagnóstico por imagem , Articulação Patelofemoral/cirurgia , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos , Resultado do Tratamento
13.
Acta Orthop Traumatol Turc ; 55(6): 513-517, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34967740

RESUMO

OBJECTIVE: The main indication for medial Unicondylar Knee Arthroplasty (UKA) is Full-Thickness Cartilage Loss (FTCL) in the isolated medial compartment of the knee. However, controversial outcomes were reported in patients with Partial-Thickness Cartilage Loss (PTCL). The aim of this study is to compare PTCL and FTCL based on intraoperative findings in medial UKA in terms of functional outcomes and complication rates requiring reoperation and revision. METHODS: Two hundred and fifteen knees of 174 patients who underwent mobile-bearing UKA between October 2014 and February 2018 for the diagnosis of symptomatic anteromedial osteoarthritis were evaluated retrospectively. A single senior surgeon evaluated the type of cartilage loss in the medial compartment intraoperatively according to the International Cartilage Repair Society classification system. Clinical outcomes were evaluated using Oxford Knee Score (OKS) and International Knee Documentation Committee (IKDC) score pre- and post-operatively at the last follow-up. Patients with PTCL and FTCL were compared in terms of their pre- and post-operative OKS and IKDC scores, and their improvements, as well as complication rates requiring reoperation and revision. RESULTS: The mean follow-up time was 33.1 ± 5.3 months. The PTCL (n = 80) and FTCL (n = 135) groups were statistically similar in terms of age (P = 0.41), gender (P = 0.921), body mass index (P = 0.165), bilaterality (P = 0.111), American Society of Anesthesiologists physical status (P = 0.218), Charlson Comorbidity Index (P = 0.74), and post-operative follow-up (P = 0.167). The mean pre-operative OKS and IKDC scores were improved from 24.5 ± 4.1 and 39.9 ± 5 to 40.3 ± 3.6 and 73.9 ± 7.7 at the last follow-up, respectively (P < 0.001). Pre-operative OKS and IKDC scores were superior in favor of the PTCL group. However, no significant difference was found between the groups in terms of post-operative OKS (P = 0.53) and IKDC (P = 0.975) scores, and their improvements (OKS, P = 0.953; IKDC, P = 0.536). The complication rates requiring reoperation was 5% (n = 11) in all patients. Of these, 9% (n = 7) from the PTCL group and 3% (n = 4) from the FTCL group were reoperated. Nevertheless, no significant difference was found between the groups (P = 0.105). CONCLUSION: In PTCL, medial UKA is a reliable surgery in terms of functional outcomes, the same as in FTCL; however, its complication rates requiring reoperation is higher without statistical significance. LEVEL OF EVIDENCE: Level III, Therapeutic Study.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Artroplastia do Joelho/efeitos adversos , Cartilagem , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Reoperação , Estudos Retrospectivos , Resultado do Tratamento
14.
Zhongguo Gu Shang ; 34(12): 1147-52, 2021 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-34965633

RESUMO

OBJECTIVE: To investigate whether shifting the femoral opening point and setting a personalized femoral valgus angle can improve the lower limb force line of total knee arthroplasty (TKA) patients with external femoral arch. METHODS: From March 2016 to October 2018, 50 patients (55 knees) with osteoarthritis with genu varus deformity combined with external femoral arch for TKA were selected. There were 10 males and 40 females. The age ranged from 63.1 to 80.5 years old, with an average of (67.8±5.8) years old. Forty-five cases were unilateral and 5 cases were bilateral. The osteoarthritis stages of 55 knees were Kellgren-Lawrence grade Ⅲ to Ⅳ; and the course of disease ranged from 2 to 10 years. PreoperativeSpecial Surgery (Hospital for Special Surgery) scores:pain was 15.20±3.52; function was 8.30±2.96;mobility was 10.15±2.85;muscle strength was 4.20±1.95;flexion deformity was 5.50±3.05;stability was 6.15±2.20; total score was 47.93±3.39. The external femoral arch angle ranged from 6.4° to 16.7°, with a mean of (10.63±2.29) °. The tibiofemoral angle ranged from 7.4° to 12.6°, with a mean of (12.04±3.59)°. The anatomical distal femoral angle ranged from 83.10° to 91.20°, with a mean of (84.55± 1.66)°. And the distance from the center of the knee joint to the lower limb line of force ranged from 2.01 to 6.00 cm, with a mean of (3.57±1.12) cm. During the replacement surgery, the femoral opening point and the valgus angle were individually set to obtain a good line of force of the lower limbs. RESULTS: Before the operation, the distance of femoral opening point ranged from 0.24 to 0.74 cm, with a mean of (0.54±0.10) cm. The distance between the internal and external condyles of the femur ranged from 6.86 to 8.12 cm, with a mean of (7.27±0.27) cm. The preoperative valgus correction angle (VCA) ranged from 7.20° to 13.80°, with a mean of (9.38±1.38) °. The post-correction valgus correction angle' (VCA') ranged from 6.10° to 9.50°, with a mean of (7.36±0.82) °. All patients were followed up, and the duration ranged from 3 to 36 months, with an average of (13.5±5.8) months. All patients obtained good knee function after operation. Three months after operation, HSS scores included pain of 25.30±3.05, function of 18.25±2.05, mobility of 16.05±0.75, muscle strength of 6.20±2.10, flexion deformity of 8.80±1.85, stability of 8.20±1.75; and the total score ranged from 90.00 to 93.00, with an average of 91.82±0.98. The total score was higher than that before operation (t=1.728, P=0.038). Postoperative X-ray examination showed that there were no signs of loosening, sinking, or osteolysis of the prosthesis. The tibiofemoral angle on the weight-bearing X-ray on the second day after surgery ranged from 1.30° to 4.90°, with a mean of (2.53±0.83) °;the angle ranged from 87.50° to 91.30°, with a mean of (88.73±0.86) °;and the distance from the center of the knee joint to the lower limb line of force ranged from 0.02 cm to 1.20 cm, with a mean of (0.23±0.05) cm; which were improved compared with those before operation (t=2.415, P=0.019;t=1.496, P=0.041;t=1.912, P=0.033). CONCLUSION: In TKA combined with external femoral arch, good lower limb force line and knee joint function can be obtained by externally shifting the femoral opening point and setting a personalized femoral valgus angle.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Idoso , Idoso de 80 Anos ou mais , Feminino , Fêmur/cirurgia , Humanos , Articulação do Joelho/cirurgia , Extremidade Inferior , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/cirurgia
15.
Medicina (Kaunas) ; 57(12)2021 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-34946274

RESUMO

Background and Objectives: Walking speed after total knee arthroplasty (TKA) is an important outcome. However, the effect of quadriceps tendon stiffness on walking speed remains unclear. This study aimed to clarify the influence of the amount of change in quadriceps tendon stiffness on the degree of change in walking speed before and after TKA. Materials and Methods: Sixteen patients who underwent TKA for knee osteoarthritis participated in this study (median age: 74.0 years (interquartile range: 64.5-75.8)). Shear-wave elastography was deployed to measure quadriceps tendon stiffness using Young's modulus. A motion analysis system was used to assess kinematic parameters and walking speed. Participants' knee circumference, range of motion, extension strength, one-leg standing time, walking pain level, and activity level were measured preoperatively and one year after TKA, and changes in values were calculated. We used path analysis to clarify the influence of the amount of change in the quadriceps tendon Young's modulus on the change in walking speed. Results: The quadriceps tendon Young's modulus negatively affected the knee flexion angle during swing (standardized partial regression coefficients (ß) = -0.513, p = 0.042). The knee flexion angle during swing positively affected step length (ß = 0.586, p = 0.017). Step length positively affected cadence (ß = 0.733, p = 0.001). Step length and cadence positively affected walking speed (ß = 0.563, p < 0.001, ß = 0.502, p < 0.001, respectively). Conclusions: The amount of change in the quadriceps tendon Young's modulus may affect the degree of change in walking speed after TKA through the amount of change in the knee flexion angle during swing, step length, and cadence. Clinically, reducing quadriceps tendon stiffness can be addressed in rehabilitation programs to increase walking speed after TKA.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Idoso , Módulo de Elasticidade , Humanos , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Amplitude de Movimento Articular , Tendões , Velocidade de Caminhada
16.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(12): 1563-1573, 2021 Dec 15.
Artigo em Chinês | MEDLINE | ID: mdl-34913313

RESUMO

Objective: To investigate the difference of total knee arthroplasty (TKA) with tantalum monoblock tibial component (TMT) and cemented tibial plateau prosthesis in patients of different ages. Methods: The clinical data of 248 patients (392 knees) who underwent primary TKA between May 2014 and May 2019 and met the selection criteria were retrospectively analyzed. There were 54 males (98 knees) and 194 females (294 knees). Of the 122 patients (183 knees), less than 65 years old, 52 (75 knees, group A1) were treated with TMT and 70 (108 knees, group B1) were treated with cemented tibial plateau prosthesis; of the 126 patients (209 knees), more than 65 years old, 57 (82 knees, group A2) were treated with TMT and 69 (127 knees, group B2) were treated with cemented tibial plateau prosthesis. The baseline data of patients, perioperative indicators [hemoglobin (Hb), hematocrit (Hct), total blood loss, unilateral operation time], effectiveness evaluation indicators [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, visual analogue scale (VAS) score, Knee Society Scoring System (KSS) score, active flexion and extension range of motion (ROM) of the knee joint], complications, and imaging indicators [tibial prosthesis varus angle (ß angle), tibial prosthesis posterior slope angle (δ angle), tibio-femoral angle, occurrence of radiolucent line, prosthesis survival rate] were recorded and compared. Results: There was no significant difference in gender, age, height, weight, body mass index, Kellgren-Lawrence grading, the length of hospital stay, and follow-up time between groups A1, B1 and groups A2, B2 ( P>0.05). The unilateral operation time in groups A1 and A2 was significantly shorter than that in the corresponding groups B1 and B2 ( P<0.05). There was no significant difference in differences of pre- and post-operative Hb and Hct and total blood loss between groups A1, B1 and groups A2, B2 ( P>0.05). There was no significant difference in preoperative effectiveness evaluation indicators between groups A1, B1 and groups A2, B2 ( P>0.05). There were significant differences in the differences of pre- and post-operative WOMAC activity and pain scores, KSS function and pain scores, and VAS scores between groups A1 and B1 ( P<0.05); there was no significant difference in WOMAC stiffness score and ROM ( P>0.05). There was no significant difference in the above indicators between groups A2 and B2 ( P>0.05). There was no significant difference in the incidence of complications (2.7% vs 6.5%, 3.7% vs 3.1%) and prosthesis survival rate (100% vs 97.2%, 100% vs 99.2%) between groups A1, B1 and groups A2, B2 ( P>0.05). During follow-up, there was no significant difference in ß angle, δ angle, and tibio-femoral angle between groups A1, B1 and groups A2, B2 ( P>0.05). In the evaluation of knee X-ray radiolucent line, 2 knees of group A1 and 2 knees of group A2 had radiolucent line at prosthesis-bone interface immediately after operation, and the radiolucent line was gradually filled by new bone, without new radiolucent line. During follow-up, 1 knee of group B1 and 1 knee of group B2 had prosthesis-bone interface radiolucent line, without radiolucent line widening or prosthesis loosening. Conclusion: TMT is recommended in patients less than 65 years old, and the two types of prostheses are available for patients nore than 65 years old. However, the long-term effectiveness of the two types of prosthesis in patients of different ages needs further follow-up.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Idoso , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Masculino , Osteoartrite do Joelho/cirurgia , Amplitude de Movimento Articular , Estudos Retrospectivos , Tantálio , Resultado do Tratamento
17.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(12): 1574-1579, 2021 Dec 15.
Artigo em Chinês | MEDLINE | ID: mdl-34913314

RESUMO

Objective: To compare the patient-reported outcomes regarding function, joint amnesia, and the quality of life after unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). Methods: The clinical data of patients who received UKA or TKA between September 2017 and June 2018 were retrospectively analyzed. After propensity score matching, 40 patients (40 knees) each in TKA group and UKA group were finally included in the study. There was no significant difference between the two groups in gender, age, body mass index, surgical side, preoperative knee range of motion, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score, clinical and function scores of knee society score (KSS) ( P>0.05). At 2 years after operation, WOMAC score, KSS clinical and function scores were performed on the two groups of patients, and compared with preoperative ones; knee injury and osteoarthritis outcome score-physical function short form (KOOS-PS), short-form 36 health survey scale (SF-36 scale), and forgotten joint score (FJS) were also performed. Results: At 2 years after operation, the total score of WOMAC, the clinical and function scores of KSS in the two groups significantly improved when compared with preoperative ones ( P<0.05), but there was no significant difference in the total score of WOMAC, the individual score of WOMAC, the clinical and function scores of KSS between the two groups ( P>0.05). The total KOOS-PS score in the UKA group was significantly lower than that in the TKA group ( t=4.243, P=0.000), and the scores of writhing/knee rotation, kneeling, and squatting in the UKA group were significantly lower than those in the TKA group ( P<0.05). The total FJS score in the UKA group was significantly higher than that in the TKA group ( t=-6.334, P=0.000). In the UKA group, the scores of 7 items were significantly lower than those of the TKA group ( P<0.05) including when walking over 15 minutes, when climbing stairs, when walking on uneven ground, when standing for long periods, when doing housework or gardening, when taking a walk or hiking, and when doing your favorite sport. The SF-36 scales of physiological function, energy, social function, emotional function, and mental health in the UKA group were significantly higher than those in the TKA group ( P<0.05). Conclusion: Compared with TKA, patients treated with UKA may have better knee function recovery, joint amnesia, and higher quality of life.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Humanos , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento
18.
Arthroscopy ; 37(11): 3324-3325, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34740408

RESUMO

Realignment of the weightbearing axis by high tibial osteotomy (HTO) can alter the forces acting on the articular cartilage within the knee, reducing the load on the medial compartment. This unloading effect is thought to allow the repair of the articular cartilage of the affected compartment. It is important to evaluate the serial changes of joint space width (JSW) after HTO for assessing the state of the cartilage and the unloading effect by HTO. However, early postoperative knee JSW change is attributable to change in the joint line convergence angle after HTO and may not reflect cartilage regeneration. In addition, the soft tissue laxity of the knee and changes in joint line convergence angle after HTO should be considered for assessing these early postoperative JSW changes.


Assuntos
Cartilagem Articular , Osteoartrite do Joelho , Cartilagem Articular/cirurgia , Humanos , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Osteotomia , Regeneração , Tíbia/cirurgia
19.
Bone Joint J ; 103-B(11): 1686-1694, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34719267

RESUMO

AIMS: To determine the relationship between articular cartilage status and clinical outcomes after medial opening-wedge high tibial osteotomy (MOHTO) for medial compartmental knee osteoarthritis at intermediate follow-up. METHODS: We reviewed 155 patients (155 knees) who underwent MOHTO from January 2008 to December 2016 followed by second-look arthroscopy with a mean 5.3-year follow-up (2.0 to 11.7). Arthroscopic findings were assessed according to the International Cartilage Repair Society (ICRS) Cartilage Repair Assessment (CRA) grading system. Patients were divided into two groups based on the presence of normal or nearly normal quality cartilage in the medial femoral condyle: good (second-look arthroscopic) status (ICRS grade I or II; n = 70), and poor (second-look arthroscopic) status (ICRS grade III or IV; n = 85) groups at the time of second-look arthroscopy. Clinical outcomes were assessed using the International Knee Documentation Committee (IKDC) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 36-Item Short Form survey. RESULTS: Significant improvements in all clinical outcome categories were found between the preoperative and second-look arthroscopic assessments in both groups (p < 0.001). At the latest follow-up, the mean IKDC and WOMAC scores in the good status group further improved compared with those at the time of second-look arthroscopic surgery (p < 0.001), which was not shown in the poor status group. The mean IKDC (good status, 72.8 (SD 12.5); poor status, 64.7 (SD 12.1); p = 0.002) and mean WOMAC scores (good status, 15.7 (SD 10.8); poor status, 21.8 (SD 13.6); p = 0.004) significantly differed between both groups at the latest follow-up. Moreover, significant correlations were observed between ICRS CRA grades and IKDC scores (negative correlation; p < 0.001) and WOMAC scores (positive correlation; p < 0.001) at the latest follow-up. Good cartilage status was found more frequently in knees with the desired range of 2° to 6° valgus correction than in those with corrections outside this range (p = 0.019). CONCLUSION: Second-look arthroscopic cartilage status correlated with clinical outcomes after MOHTO at intermediate-term follow-up, despite the relatively small clinical differences between groups. Cite this article: Bone Joint J 2021;103-B(11):1686-1694.


Assuntos
Artroscopia , Cartilagem Articular/patologia , Osteoartrite do Joelho/cirurgia , Osteotomia/métodos , Cirurgia de Second-Look/métodos , Tíbia/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
20.
Acta Orthop Traumatol Turc ; 55(5): 417-421, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34730528

RESUMO

OBJECTIVE: The aim of this study was to determine which type of knee arthroplasty is easier to forget by comparing levels of joint awareness evaluated with the Forgotten Joint Score (FJS-12) after unicondylar versus total knee arthroplasty. METHODS: Patients who underwent either unicondylar or total knee arthroplasty due to primary gonarthrosis were retrospectively identified and then divided into 2 groups: the TKA group (218 patients; mean age = 68.93 ± 7.14 years) and the UKA group (131 patients; mean age = 60.39 ± 7.03 years). The status of joint awareness after knee replacement surgery was assessed using the Turkish version of the FJS-12 at the final follow-up by telephone interview. Also, The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and The EuroQol five-dimensional (EQ-5D) scores were obtained to assess the clinical status of the patients. RESULTS: The mean follow-up was 2.8 years (range = 24-49 months) in the TKA group and 3.2 years (range = 24-50 months) in the UKA group. The FJS-12 was significantly higher in the UKA group (73.60 ± 9.95) than in the TKA group (64.88 ± 9.47) (P = .001). The WOMAC score was significantly better in the UKA group (81.39 ± 9.84) than in the TKA group (74.92 ± 9.99) (P = .001). No significant difference in EQ-5D existed between the groups (0.76 ± 0.14 for the TKA group, 0.79 ± 0.17 for the UKA group; P = .441). In terms of gender, the FJS-12 showed no differences between the groups; however, more favorable scores were recorded in younger patients with UKA. CONCLUSION: The results of this study have demonstrated that UKA may be better than TKA in terms of the patient perception of pain, stiffness, and physical functioning. LEVEL OF EVIDENCE: Level IV, Therapeutic Study.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Idoso , Artroplastia do Joelho/efeitos adversos , Humanos , Articulação do Joelho/cirurgia , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
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