Predictive Factors of “Forgotten Knee” Acquisition After Total Knee Arthroplasty: Long-Term Follow-Up of a Large Prospective Cohort

Eymard, Florent; Charles-Nelson, Anaïs; Katsahian, Sandrine; Chevalier, Xavier; Bercovy, Michel

doi:10.1016/j.arth.2016.06.020

Cited by 12 publications

(15 citation statements)

References 39 publications

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“…We also found that QoL advanced over time, consistent with other studies that have found that QoL at 3 months after TKA was better compared to that before TKA and that people resumed the vast majority of their daily activities at 12 months after TKA [ 9 , 26 ]. For a patient to undergo TKA, it must be perceived as high value in improving knee functions and relieving pain, and postoperative high intensity exercise and remote rehabilitation may be helpful in reducing joint stiffness [ 27 , 28 ].…”

Section: Discussionsupporting

confidence: 90%

The dynamic impact of Joint Awareness on Quality of Life after Total Knee Arthroplasty: a longitudinal study

Zhang

et al. 2022

J Orthop Surg Res

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Background Joint Awareness is thought to be closely linked to Quality of Life (QoL) for patients undergoing Total Knee Arthroplasty (TKA), yet to date there have been no longitudinal studies to explore how Joint Awareness actually affects QoL. The purpose of this study was therefore to examine the development of Joint Awareness and QoL after TKA as well as the dynamic impact of Joint Awareness on QoL. Methods A total of 342 patients were followed up at 3 months (T1), 6 months (T2), and 12 months (T3) after TKA. Joint Awareness was evaluated using the Forgotten Joint Score-12 (FJS-12), and QoL was measured by SF-36. We used repeated measures analysis of variance to estimate the development of Joint Awareness and QoL and employed a cross-lagged model to examine the dynamic relationship between Joint Awareness and QoL. Results Both Joint Awareness and QoL improved with postoperative time (p < 0.001). Importantly, T1 Joint Awareness positively predicted T2 physical QoL (p < 0.001), and T2 Joint Awareness positively predicted T3 physical QoL (p < 0.001). Nevertheless, Joint Awareness had no predictive effect on mental QoL (p = 0.082–0.931). Conclusions In different periods after TKA, Joint Awareness and QoL both increased monotonically, and Joint Awareness positively predicted physical QoL. These findings indicate that focusing on Joint Awareness may be a priority when trying to improve the postoperative life of patients.

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Section: Discussionsupporting

confidence: 90%

The dynamic impact of Joint Awareness on Quality of Life after Total Knee Arthroplasty: a longitudinal study

Zhang

et al. 2022

J Orthop Surg Res

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“…Despite satisfying mean subjective scores (.80 out of 100), only one-third of the reviewed patients had a ''forgotten knee.'' 10 Among all operated knees at 19-year minimum followup, 78% had stage 1 or 2 tibiofemoral OA (lateral and/or medial). The addition of an LET was associated with a significantly increased risk of lateral tibiofemoral OA; however, partial lateral meniscectomy was significantly associated with lateral OA, and lateral meniscal lesions were significantly more frequent in the BTB-LET knees with radiographs than in the BTB group.…”

Section: Discussionmentioning

confidence: 95%

“…Recent studies have reported good functional results after ACL surgery in older patients, 5 perhaps indicating that some of these patients may benefit from revision. Despite satisfying mean subjective scores (>80 out of 100), only one-third of the reviewed patients had a “forgotten knee.” 10…”

Section: Discussionmentioning

confidence: 99%

“…This study describes the most recent follow-up of this cohort at a mean 19 years after ACLR. An examiner independent from the original surgeon recorded patient-reported outcome scores (subjective International Knee Documentation Committee [IKDC] score, Lysholm score, and “forgotten knee” score 10 ) and subsequent surgical procedures (including revision ACLR). Patients willing to return for on-site evaluation underwent a standard clinical examination of the operated and contralateral knees, which included range of motion, Lachman test, and pivot-shift test.…”

Section: Methodsmentioning

confidence: 99%

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A Randomized Controlled Trial of Bone–Patellar Tendon–Bone Anterior Cruciate Ligament Reconstruction With and Without Lateral Extra-articular Tenodesis: 19-Year Clinical and Radiological Follow-up

et al. 2020

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Background: Arthroscopic anterior cruciate ligament (ACL) reconstruction (ACLR) with a bone–patellar tendon–bone graft (BTB) is a reliable surgical option for the control of anterior knee laxity after ACL injury. The addition of a lateral extra-articular tenodesis (LET) may improve control of rotation knee laxity and improve short-term graft survival in high-risk patients. Purpose: The aims of this study were to compare long-term patient-reported outcomes, graft survival, and risk of osteoarthritis between ACLR with and without LET. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: This study included 121 consecutive knees (120 patients) presenting to a single center with an ACL rupture between 1998 and 1999. In total, 61 knees were randomized to an isolated BTB ACLR, and 60 knees were randomized to a BTB ACLR with an extra-articular lateral tenodesis with gracilis tendon (modified Lemaire). Results: Eighty knees in 79 patients (66%) were available for follow-up at a postoperative mean of 19.4 years (range, 19-20.2). Of those patients, 43 had a clinical examination and completed patient-reported outcome questionnaires, and the other 37 patients were evaluated through the questionnaires alone. Standard radiographs were available for 45 patients and laximetry (TELOS) for 42 patients. Mean subjective International Knee Documentation Committee score at last follow-up was 81.8, and no differences were noted between the BTB and BTB-LET groups ( P = .7). Two-thirds of patients were still participating in pivoting sports. A total of 17 knees (21%) experienced a graft failure, 5 of which (6%) underwent revision ACLR. There was no significant difference in graft failure risk between the BTB group (29%) and the BTB-LET group (13%; P = .1). Lateral tibiofemoral osteoarthritis was significantly more frequent in the BTB-LET group (59%) as compared with the BTB group (22%; P = .02). Lateral compartment osteoarthritis was correlated with partial lateral meniscectomy. Conclusion: There were no significant differences in long-term patient-reported outcomes after ACLR with or without an LET. LET may increase the risk of lateral compartment osteoarthritis at long-term follow-up. There was a trend toward decreased graft failure risk with the addition of LET but this study was underpowered to assess this outcome.

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“…It is possible that this technique may be closer to achieving the "forgotten knee" as described by Eymard and colleagues. 24,25…”

Section: Discussionmentioning

confidence: 99%

An Extramedullary Spacing Block Technique to Restore Native Coronal Limb Alignment in TKA

Dungy

Jesus

2020

Techniques in Orthopaedics

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Background: Historically, the femoral and tibial preparation for a total knee arthroplasty (TKA) are executed in isolation and then soft tissue releases are used to obtain a balanced knee. We present the clinical outcomes associated with a novel surgical method that links the tibial and femoral resections, avoids soft tissue releases, is performed extramedullary, and does not require special scans, robotics, or rapid prototype blocks. Materials and Methods:We measured hip, knee, ankle alignment radiographs preoperatively and postoperatively on 433 consecutive TKAs performed between November 2016 and August 2019. A new surgical technique called the linked and tensioned extramedullary resections (LATER technique) for both extension and flexion gap balancing was utilized without any soft tissue releases.Results: One hundred thirty-four knees were found to have severe malalignment preoperatively ( ≥ 10 degrees of varus or valgus deformities). The average angular correction was 12 degrees toward neutral alignment. Of the entire cohort, 89.2% of patients reported being completely or mostly satisfied. Patients reported "a lot of improvement" or "back to normal" (92.3%). Conclusions:The LATER technique improves coronal alignment following a complex primary TKA. Contemporary TKA can be balanced without ligament releases. The avoidance of intramedullary violation and soft tissue releases decreased intraoperative blood loss and trauma. This technique also avoids the complexities of navigation, the complications associated with fat embolism, and the manufacturing of rapid prototype blocks. The LATER technique of coronally tensioned alignment is simple to use and has excellent patient-reported satisfaction and improvement scores.

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Predictive Factors of “Forgotten Knee” Acquisition After Total Knee Arthroplasty: Long-Term Follow-Up of a Large Prospective Cohort

Cited by 12 publications

References 39 publications

The dynamic impact of Joint Awareness on Quality of Life after Total Knee Arthroplasty: a longitudinal study

The dynamic impact of Joint Awareness on Quality of Life after Total Knee Arthroplasty: a longitudinal study

A Randomized Controlled Trial of Bone–Patellar Tendon–Bone Anterior Cruciate Ligament Reconstruction With and Without Lateral Extra-articular Tenodesis: 19-Year Clinical and Radiological Follow-up

An Extramedullary Spacing Block Technique to Restore Native Coronal Limb Alignment in TKA

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