Analysis of total knee replacements in a South Indian Institute

Authors

  • Maheshwar Lakkireddy Department of Orthopaedics, Nizam’s Institute of Medical sciences, Punjagutta, Hyderabad, Telangana, India
  • K. K. Kiran Kumar Department of Orthopaedics, Nizam’s Institute of Medical sciences, Punjagutta, Hyderabad, Telangana, India
  • Madhulatha Karra Department of Biochemistry, Nizam’s Institute of Medical sciences, Punjagutta, Hyderabad, Telangana, India
  • Srikanth Palthi Department of Orthopaedics, Nizam’s Institute of Medical sciences, Punjagutta, Hyderabad, Telangana, India
  • Chandrashekar Patnala Department of Orthopaedics, Nizam’s Institute of Medical sciences, Punjagutta, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20180046

Keywords:

Osteoarthritis, Total knee replacement, Diabetes mellitus, Hypertension, Component size mismatch

Abstract

Background: Total knee replacement (TKR) is the most widely practised elective surgical procedure for advanced osteoarthritic patients globally. There is paucity of data on TKR’s in south Indian population. This study was aimed at analysing the peri-operative data of primary TKR’s to ease in customising the imported implants for our population.

Methods: Data on 261 TKR’s performed in our institute over 40 months was collected. Categorical variables like age, gender, size of components used, co-morbidities and type of implants used were analysed.

Results: Out of 220 patients with 261 knees, 141 were females (173 knees) and 79 were males (88 knees). The age group of the cohort was 60±11.2 years (Mean±SD). Diabetes and Hypertension (n=152) were the commonest co morbidities. The Cruciate Retaining (CR) type of prosthesis was used to the maximum extent (n=218). Size 3 femoral and tibial component was the commonly used in males and size 2 in females. 143(54.8%) knees had tibio-femoral component mismatch.  

Conclusions: This study gives a reasonable insight into various aspects of the total knee replacements in a South Indian Institute. This data would be useful for manufacturing suitable implants customised for our population in the context of imported implants being in vogue. It also helps the operating surgeon to appropriately order for the desirable implants well in advance lest he should struggle intra operatively for want of better clinical outcome.

Author Biographies

Maheshwar Lakkireddy, Department of Orthopaedics, Nizam’s Institute of Medical sciences, Punjagutta, Hyderabad, Telangana, India

Associate Professor

Department of Orthopaedics

K. K. Kiran Kumar, Department of Orthopaedics, Nizam’s Institute of Medical sciences, Punjagutta, Hyderabad, Telangana, India

Associate Professor

Department of Orthopaedics

Madhulatha Karra, Department of Biochemistry, Nizam’s Institute of Medical sciences, Punjagutta, Hyderabad, Telangana, India

Senior Resident

Department of Biochemistry

Srikanth Palthi, Department of Orthopaedics, Nizam’s Institute of Medical sciences, Punjagutta, Hyderabad, Telangana, India

Junior Resident

Department of Orthopaedics

Chandrashekar Patnala, Department of Orthopaedics, Nizam’s Institute of Medical sciences, Punjagutta, Hyderabad, Telangana, India

Professor & HOD

Department of Orthopaedics

References

Kramer JS, Yelin EH, Epstein WV. Social and economic impacts of four musculoskeletal conditions: a study using national community-based data. Arthritis Rheum. 1983;26:901-7.

Peyron JG, Altman RD. The epidemiology of osteoarthritis. In: Moskowitz RW, Howell DS, Goldberg VM, Mankin HJ, eds. Osteoarthritis: diagnosis and medical/surgical management. 2nd ed. Philadelphia: W.B. Saunders; 1992: 15-37.

Hawker GA, Wright JG, Coyte PC, et al. Health-related quality of life after knee replacement. J Bone Joint Surg Am. 1998;80:163-73.

Singh JA, Tugwell P, Zanoli G, Wells GA. Total joint replacement surgery for knee osteoarthritis and other non-traumatic diseases: a network meta-analysis (Protocol). Cochrane Database Systematic Rev. 2015;6:CD011765.

Pachore JA, Vaidya SV, Thakkar CJ, Bhalodia HP, Wakankar HM. ISHKS joint registry: A preliminary report. Indian J Orthop. 2013;47:505-9.

Bheeshma Ravi, Ruth Croxford, William M. Reichmann, Elena Losina, Jeffrey N. Katz, Gillian A. Hawker. The changing demographics of total joint arthroplasty recipients in the United States and Ontario from 2001 to 2007. Best Practice Res Clin Rheumatol 2012;26(5):637-47.

Jasvinder A Singh. Epidemiology of Knee and Hip Arthroplasty: A Systematic Review. Open Orthop J. 2011;5:80-5.

Naushad Hussain AR, Kami P, Kumar S. A retrospective analysis of patients undergoing total knee replacement using knee society score. J Cont Med A Dent. 2017;5(2):42-4.

Jain JP. Knee prosthesis sizes in Indian patients undergoing total knee replacement. Int Surg J. 2015;2:348-51.

Slemenda C, Brandt KD, Heilman DK, Mazzuca S, Braunstein EM, Katz BP, et al. Quadriceps weakness in osteoarthritis of knee. Ann Intern Med. 1997;127(2):97-104.

Jain NB, Higgins LD, Ozumba D, Guller U, Cronin M, Pietrobon R, et al. Trends in epidemiology of knee arthroplasty in the United states, 1990-2000. Arthritis Rheumatism. 2005;52(12):3928-33.

Hawker GA, Wright JG, Coyte PC, Williams JI, Harvey B, Glazier R, et al. N Engl J Med. 2000;342:1016-22.

Ahmad Hafiz Z, Masbah O, Ruslan G. Total Knee Replacement: 12 years retrospective review and experience. Malays Orthop J. 2011;5(1):34-9.

Kremers HM, Larson DR, Crowson CS, Kremers WK, Washington RE, Steiner CA, et al. Prevalence of Total Hip and Knee Replacement in the United States. J Bone Joint Surg Am. 2015;97(17):1386–97.

Piano LPA, Golmia RP, Scheinberg M. Total Hip and Knee Joint Replacement: perioperative clinical aspects. Einstein. 2010;8(3):352-3.

Mohan CB, Srinivasan DK, Mohan KM. Comparative Study of Cruciate Stabilizing Vs Cruciate Retaining Prosthesis in Total Knee Replacement. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS). 2014;13(4):38-40.

Schai PA, Thornhill TS, Scott RD. Total knee arthroplasty with the PFC system: results at a minimum of ten years and survivorship analysis. J Bone Joint Surg [Br]. 1998;80:850-8.

Mahfouz M, Fatah E, Bowers L, Scuderi G. Three dimensional morphology of the knee reveals ethnic differences. Clin Orthop Relat Res. 2012;470:172- 85.

Ewe TW, Ang HL, Chee EK, Ng WM. An analysis of the relationship between the morphometry of the distal femur, and total knee arthroplasty implant design. Malays Orthop J. 2009;3(2):24-8.

Downloads

Published

2018-02-23

Issue

Section

Original Research Articles