Importance of clinical and radiological assessment of patient of osteoarthritis knee foroptimum outcome in total knee replacement

Authors

  • Soutrik Kundu Department of Orthopaedics, Bharatratna Dr. Babasaheb Ambedkar Municipal General Hospital, Mumbai, Maharashtra, India
  • Kosturi Dakshit Department of Community Medicine, LTM Medical College and Municipal General Hospital, Mumbai, Maharashtra, India
  • Rohit Nirbhay Garg Department of Orthopaedics, Bharatratna Dr. Babasaheb Ambedkar Municipal General Hospital, Mumbai, Maharashtra, India
  • Kumarswami Ramulu Dussa Department of Orthopaedics, T.N.M.C. and B.Y.L. Nair Charitable Hospital, Mumbai Central, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20240416

Keywords:

Arthroplasty, Knee society score, Kellgren and Lawrence classification

Abstract

Background: Total knee replacement (TKR) provides symptomatic relief in patients with severe arthritis by removing pathologic joint tissue and restoration of the joint anatomy and function by the replacing with metal or plastic components leading to more stable biomechanics. Inspite of all advances in the surgical techniques 1 out of 5 people who undergo TKA remain unsatisfied. Clinical and radiological grading of osteoarthritis of knee may be an important prognostic marker to assess the outcome following TKR.

Methods: Study conducted was retrospective study. Pre-op routine and clinical assessment data noted from departmental records. Correlation between ‘initial knee society score’ (KSSi) and ‘radiological severity’ in terms of (Kellgren-Lawrence) grade and varus angle with ‘change in knee society score’ (ΔKSS) assessed to reach at conclusion.

Results: Lower KSS values, higher KL grading, higher femorotibial angle and were associated significantly with higher change in KSS values, i.e. better outcome.

Conclusions: Severe OA knee with high FTA and higher KL grade has shown better outcome following TKA. In early stages it is better to manage the patient conservatively with medications and physiotherapy.

References

Varacallo M, Chakravarty R, Denehy K, Star A. Joint perception and patient perceived satisfaction after total hip and knee arthroplasty in the American population. J Orthop 2018;15(2):495-9.

Karachalios T, Komnos G, Koutalos A. Total hip arthroplasty: Survival and modes of failure. EFORT Open Rev. 2018;3(5):232-9.

Morshed S, Bozic KJ, Ries MD, Malchau H, Colford JM. Comparison of cemented and uncemented fixation in total hip replacement. Acta Orthop. 2007;78(3):315-26.

Laupacis A, Bourne R, Rorabeck C, Feeny D, Wong C, Tugwell P et al. The effect of elective total hip replacement on health-relat. J Bone Joint Surg Am. 1993;75(11):1619-26.

Berend KR, Berend ME, Dalury DF, Argenson JN, Dodd CA, Scott RD. Consensus Statement on Indications and Contraindications for Medial Unicompartmental Knee Arthroplasty. J Surg Orthop Adv. 2015;24(4):252-6.

Bhandarkar P, Priti P, Chander S, Nandan K. Prevalence of osteoarthritis knee: four year study based on digital records of comprehensive healthcare setup at Mumbai, India. Int J Community Med Public Heal. 2016;3(5):1049-53.

The Knee Society. 2011 Knee Society Knee Scoring System | Licensed User Manual The 2011 Knee Society Knee Scoring System© LICENCED USER MANUAL. 2011.

Kohn MD, Sassoon AA, Fernando ND. Classifications in Brief: Kellgren-Lawrence Classification of Osteoarthritis. Clin Orthop Relat Res. 2016;474(8):1886–93.

Riis A, Rathleff MS, Jensen MB, Simonsen O. Low grading of the severity of knee osteoarthritis pre-operatively is associated with a lower functional level after total knee replacement: A prospectivective cohort study with 12 months’ follow-up. Bone Jt J. 2014;96(11):1498-502.

Schnurr C, Jarrous M, Güdden I, Eysel P, König DP. Pre-operative arthritis severity as a predictor for total knee arthroplasty patients’ satisfaction. Int Orthop. 2013;37(7):1257.

Scott CEH, Oliver WM, MacDonald D, Wade FA, Moran M, Breusch SJ. Predicting dissatisfaction following total knee arthroplasty in patients under 55 years of age. Bone Jt J. 2016;98-B(12):1625-34.

Nilsdotter AK, Toksvig-Larsen S, Roos EM. A 5 year prospective study of patient-relevant outcomes after total knee replacement. Osteoarthr Cartil. 2009;17(5):601-6.

Valdes AM, Doherty SA, Zhang W, Muir KR, Maciewicz RA, Doherty M. Inverse Relationship Between Preoperative Radiographic Severity and Postoperative Pain in Patients with Osteoarthritis who Have Undergone Total Joint Arthroplasty. Semin Arthritis Rheum. 2012;41(4):568-75.

Downloads

Published

2024-02-26

Issue

Section

Original Research Articles