The value of preoperative grade of radiographic and histological changes in predicting pain relief after total knee arthroplasty for osteoarthritis

Lundblad, Henrik; Kreicbergs, Andris; Söderlund, Veli; Ulfgren, Ann‐Kristin; Stiller, Carl‐Olav; Jansson, Karl-Åke

doi:10.1007/s00167-011-1821-5

Cited by 19 publications

(24 citation statements)

References 32 publications

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“…Not all patients had x-rays of both knees at T0, for example. Nevertheless, evidence of association between OA-related HRQL measures and TKR outcomes [8–10, 12, 14, 15, 36, 37, 46] seems to be more robust than evidence of relationship between radiographic findings and TKR outcomes [36, 47]. As all patients included in the study were recruited from American institutions, the generalizability of our findings to other countries may also be limited.…”

Section: Discussionmentioning

confidence: 91%

Improvement following total knee replacement surgery: Exploring preoperative symptoms and change in preoperative symptoms

Vina

Hannon

Kwoh

2016

Seminars in Arthritis and Rheumatism

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Objective To determine whether changes in preoperative osteoarthritis (OA) symptoms are associated with improvement after total knee replacement (TKR) and to identify predictors of clinically significant improvement. Methods Data on Osteoarthritis Initiative participants who were annually assessed and underwent TKR were included. T0 was the assessment prior to TKR while T-1 was the assessment prior to that. T+2 was the second assessment after TKR. We compiled data on the Western Ontario and McMaster Universities OA Index (WOMAC), OA-related symptoms and radiographic severity. We defined clinically significant improvement as improvement in WOMAC total score ≥ to the minimal important difference (MID) (0.5 SD of mean change) between T0 and T+2 and also considered other definitions of improvement. Logistic regression models were performed to evaluate the relationship between improvement and preoperative measures. Results Improved (n=211) compared to unimproved (n=58) patients had greater worsening of their WOMAC pain (p=0.002) and disability (p<0.001) from T-1 to T0. Preoperative measures as predictors of improvement included: higher WOMAC disability (OR 1.08, p<0.001), presence of chronic OA symptoms in the surgical knee (OR 5.77, p=0.033), absence of OA-related symptoms in the contralateral knee (OR 9.25, p<0.001), exposure to frequent knee-bending (OR 3.46, p=0.040), and having a Kellgren-Lawrence x-ray grade of ≥2 in the contralateral knee (OR 4.71, p=0.010). Conclusions More than 75% of participants had improvement after TKR. Improved patients were more likely to have escalation of OA pain and disability prior to surgery than unimproved patients. Other pre-operative measures predicted improvement after TKR.

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Section: Discussionmentioning

confidence: 91%

Improvement following total knee replacement surgery: Exploring preoperative symptoms and change in preoperative symptoms

Vina

Hannon

Kwoh

2016

Seminars in Arthritis and Rheumatism

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“…The VAS was used to evaluate the knee pain of subjects. During the study, the patients rated their pain on the 100 mm horizontal, linear scale of 0 to 10 with a higher score indicating more severe pain10 ) . The function of knee joints was evaluated based on functional activities measured by the Knee Society Knee Score (KSFS), which encompasses pain, range of motion, stability, flexion contracture and distance of walking.…”

Section: Methodsmentioning

confidence: 99%

The comparison of clinical features and quality of life after total knee replacement

2017

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[Purpose] The purpose of this study is to provide fundamental information for efficient management of patients after a total knee replacement (TKR) through the evaluation of changes of range of motion, pain, functional level, and quality of life. [Subjects and Methods] For a total of 63 knee osteoarthritis patients, VAS, KSKS, KSFS, HSS, WOMAC scores and quality of life were evaluated for functional levels at pre-operation, post-operation, six months after operation, and 12 months after operation. [Results] After the TKR operations, participants showed significant improvement in KSKS, KSFS, WOMAC, and SF-36 scores when compared to pre-operation. [Conclusion] After a TKR operation, ROM, and pain management, along with a therapeutic program for improvement of function, should be conducted 6 months after the operation.

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“…Total knee arthroplasty (TKA) has been established as reliable treatment for osteoarthritis of the knee [1]. Axial alignment of the limb with restoration of the mechanical axis is a determinant of the outcome [2].…”

Section: Introductionmentioning

confidence: 99%

Are MRI-based, patient matched cutting jigs as accurate as the tibial guides?

Conteduca¹,

Iorio²,

Mazza³

et al. 2012

International Orthopaedics (SICOT)

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Purpose The aim of this study is to evaluate the accuracy of VISIONAIRE (Smith & Nephew Inc., Memphis, TN, USA) Patient Matched cutting tibial jigs in comparison with extramedullary (EM) tibial instrumentation by analysing data as detected by intra-operative use of VectorVision knee navigation software from BrainLAB (Redwood City, CA, USA). Methods Twelve patients were selected for unilateral total knee replacement (TKR). They underwent a full-length weight-bearing anteroposterior (AP) radiograph and magnetic resonance imaging (MRI). During surgery, once the EM guides were placed and fixed on the tibia, the orientation in the coronal and sagittal planes was checked by the navigator and then compared with the data obtained by measuring the orientation of VISIONAIRE Patient Matched cutting tibial jigs. An unsatisfactory result was considered an error ≥2°in both coronal and sagittal planes for the tibial component as a possible error of 4°could result. Results In the coronal plane the mean deviation of the EM tibial guides from the ideal alignment (0°) was 0.7±0.39°a nd of the VISIONAIRE was 129±1.55°(P00.22). In the sagittal plane the mean deviation of the EM tibial guides from 3°of posterior slope was −1.62±1.78°and of the VISIONAIRE was +1.16±4.29°(P<0.05). Negative values indicate a more posterior slope from the ideal and positive values an anterior slope. Conclusions This preliminary study documented only a fair accuracy of the method with a consistent risk of error of more of 3°especially in the sagittal plane. We could speculate that the problem in the sagittal plane was due to the fact that the pre-operative protocol does not include a lateral X-ray projection of the knee and only includes an AP standing X-ray of the straight leg and MRI.

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The value of preoperative grade of radiographic and histological changes in predicting pain relief after total knee arthroplasty for osteoarthritis

Cited by 19 publications

References 32 publications

Improvement following total knee replacement surgery: Exploring preoperative symptoms and change in preoperative symptoms

Improvement following total knee replacement surgery: Exploring preoperative symptoms and change in preoperative symptoms

The comparison of clinical features and quality of life after total knee replacement

Are MRI-based, patient matched cutting jigs as accurate as the tibial guides?

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