Patient-reported Outcome Correlates With Knee Function After a Single-design Mobile-bearing TKA

Abstract

With substantial interest devoted to improving knee flexion after TKA, it is important to document the relationship between high range of motion and patient-rated outcomes shown. We therefore asked whether single-design high-flexion mobile-bearing posterior-stabilized TKA resulted in: (1) improved knee function; (2) satisfying subjective results; (3) participation recreational and sporting activities; and (4) function correlated to the final range of motion. We prospectively followed 445 consecutive patients having 516 TKAs from September 2000 to January 2005. The same high-flexion posterior-stabilized mobilebearing implant was used in all patients. Mean patient age was 71 ± 8 years and mean body mass index was 28 ± 4 kg/m 2 . The minimum clinical followup was 2 years (mean, 3 years; range, 2-4 years). The postoperative range of knee flexion was 128°± 4°and the mean Knee Society function and knee scores were 91 ± 6 and 96 ± 3, respectively. Eighty-two percent of patients were involved in sporting activities and 86% returned to their previous level of activity. These data confirm that high postoperative range of knee flexion improve patient-rated outcomes.

High-Flexion Total Knee Replacement: Functional Outcome at One Year

“…Range of motion did not correlate with patient-reported function in high-flexion activities. This contrasts with the results of Argenson et al [29], who found that knee flexion greater than 125°after high-flexion TKR was associated with improved patient-reported outcomes as measured by KOOS subscores. These authors did not specifically evaluate function in deep knee flexion, and we did not utilize the KOOS instrument.…”

Do Stemmed Tibial Components in Total Knee Arthroplasty Improve Outcomes in Patients With Obesity?

“…In one study, however, analyzing the results of 67 patients undergoing TKA for an association of obesity with pain outcomes [17], BMI of 35 to 40 kg/m 2 was associated with higher pain scores in multivariable-adjusted models that included age, gender, and comorbidities. In our earlier experience [2], pain at the proximal aspect of the tibia was observed for obese women. It was our hypothesis that a stem would limit the effect of the load during gait and consecutively limit the pain.…”

“…Recent studies concluded that consideration should be given to additional tibial fixation in patients with obesity [1]. Based on our clinical experience [2] and the results of recent studies [1,6,23] we hypothesized that a stemmed tibial component would improve function, patient-reported outcomes, and reduce complications after TKA in patients with obesity. Therefore, it was our aim to compare (1) function and pain (as measured by the new KSS, KOOS, and VAS pain scores); (2) quality of life (as measured by SF-12); and (3) mechanical complications and premature revision (defined as revision before 2 years) between patients with obesity undergoing TKA (BMI [ 30 kg/m 2 ) who received either a stemmed or an unstemmed tibial Although some differences in pain and function were found in favor of stemmed tibial components, in many other important areas, we found no such differences; and, importantly, the observed differences were small in magnitude and so were unlikely to have been clinically important.…”

“…Stems on tibial components may limit the micromotion and improve the load distribution, particularly on patients with obesity [23], so stemmed tibial components may represent one such choice [1,6,23]. Based on our clinical experience [2] and the results of those other studies [1,6,23], we hypothesized that a stemmed tibial component would improve patientreported outcomes for function and quality of life after TKA in patients with obesity. Because particular complications such as intraoperative fractures have been described in patients treated with stemmed components [7], we felt it important also to investigate potential drawbacks of stemmed tibial components as well.…”

In vivo kinematics of high-flex mobile-bearing total knee arthroplasty, with a new post-cam design, in deep knee bending motion

“…Total knee arthroplasty (TKA) procedures require high functionality and durability and deep knee flexion is considered to be especially important as an indicator of higher function [1]. Many high-flex type prostheses have been developed to enable deep knee flexion.…”