Association between limb alignment and patient-reported outcomes after total knee arthroplasty using an implant that reproduces anatomical geometry.
J Orthop Surg Res
; 13(1): 320, 2018 Dec 17.
Article
in En
| MEDLINE
| ID: mdl-30558616
ABSTRACT
BACKGROUND:
A kinematically aligned (KA) total knee arthroplasty (TKA) is expected to improve patient satisfaction, but its effect remains controversial. We investigated differences in patient-reported outcomes (PROs) between KA and non-KA TKAs using an implant that reproduces anatomical geometry.METHODS:
TKAs for varus deformity were performed in consecutive 129 patients (149 knees) via a measured resection technique with conventional instruments. The femorotibial angle (FTA), hip-knee-ankle angle (HKAA), and the angle between the joint line and the line perpendicular to the mechanical axis (AJLMA) were measured postoperatively (mean 13.6 months), and an AJLMA of ≥ 2° was defined as kinematic alignment. Patients were assigned to two or three alignment categories in each measurement method, and the Knee Society Scores (KSS) and Japanese Knee Injury and Osteoarthritis Outcome Scores (J-KOOS) was compared among the groups.RESULTS:
For patients assessed by FTA, an ADL-related J-KOOS subscale (J-KOOS-A) showed a significant difference between valgus and varus outliers (p < 0.05). When assessed by HKAA, neither the KSS nor J-KOOS subscales were significantly different among groups. When assessed by AJLMA, J-KOOS-A was significantly different between groups, and a group for AJLMA of ≥ 2° had higher scores than a group for AJLMA of < 2° (95% CI 0.323-7.763; p < 0.05).CONCLUSIONS:
Patients with an AJLMA of ≥ 2° reported significantly higher patient's satisfaction regarding ADL. This suggests the importance of restoration of the physiological joint line which can be achieved via KA TKAs.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Arthritis
/
Bone Malalignment
/
Arthroplasty, Replacement, Knee
/
Knee Prosthesis
Type of study:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Orthop Surg Res
Year:
2018
Document type:
Article
Affiliation country:
Japan