학술논문
Radiographic Predictors of Patient Satisfaction Following Primary Total Knee Arthroplasty
Document Type
Report
Author
Source
Bulletin of the NYU Hospital for Joint Diseases. April 2018, Vol. 76 Issue 2, p105, 7 p.
Subject
Language
English
ISSN
1936-9719
Abstract
Total knee arthroplasty (TKA) has been hailed as one of the most successful operations in modern medicine, with rapidly increasing rates of patients undergoing TKA in the past two decades. [...]
Background: Predicting satisfaction following total knee arthroplasty (TKA) continues to be a clinical challenge. We sought to quantify radiographic variables associated with clinical improvement and satisfaction following TKA. Methods: We reviewed a consecutive series of primary TKAs performed by a single surgeon with a minimum 2-year follow-up. Radiographic variables assessed included preoperative and postoperative mechanical axis alignment, osteophyte size and location, and the presence of tibial or patella subluxation. Measurements were taken using a calibrated ruler and goniometer using digital radiographs. Knee Society Scores (KSS), satisfaction, and range of motion (ROM) were prospectively collected. Results: A total 155 TKAs were followed with a minimum 2.3 year follow-up (mean: 4.2 [+ or -] 0.85). Eleven were not satisfied, 9 were satisfied with minor complaints, and 131 were completely satisfied after TKA. Increasing size of patella and lateral compartment osteophytes, particularly greater than 5 mm, was significantly associated with improvement in KSS knee scores (p< 0.05). Patient satisfaction was also strongly associated with these variables and appeared independent of mechanical axis alignment. A regression model demonstrated that lateral patella osteophytes and lateral compartment osteophytes continued to have a significant association with improvement in KSS knee scores after controlling for potential confounders. Discussion and Conclusion: We observed a significant association between size of patella and lateral compartment osteophytes and improvement in KSS knee scores following TKA. These radiographic variables were also predictive of satisfaction following TKA. Knee Society function scores were not significantly associated with the radiographic variables assessed in this study. These findings may help guide clinician and patient expectations regarding improvement following TKA.
Background: Predicting satisfaction following total knee arthroplasty (TKA) continues to be a clinical challenge. We sought to quantify radiographic variables associated with clinical improvement and satisfaction following TKA. Methods: We reviewed a consecutive series of primary TKAs performed by a single surgeon with a minimum 2-year follow-up. Radiographic variables assessed included preoperative and postoperative mechanical axis alignment, osteophyte size and location, and the presence of tibial or patella subluxation. Measurements were taken using a calibrated ruler and goniometer using digital radiographs. Knee Society Scores (KSS), satisfaction, and range of motion (ROM) were prospectively collected. Results: A total 155 TKAs were followed with a minimum 2.3 year follow-up (mean: 4.2 [+ or -] 0.85). Eleven were not satisfied, 9 were satisfied with minor complaints, and 131 were completely satisfied after TKA. Increasing size of patella and lateral compartment osteophytes, particularly greater than 5 mm, was significantly associated with improvement in KSS knee scores (p< 0.05). Patient satisfaction was also strongly associated with these variables and appeared independent of mechanical axis alignment. A regression model demonstrated that lateral patella osteophytes and lateral compartment osteophytes continued to have a significant association with improvement in KSS knee scores after controlling for potential confounders. Discussion and Conclusion: We observed a significant association between size of patella and lateral compartment osteophytes and improvement in KSS knee scores following TKA. These radiographic variables were also predictive of satisfaction following TKA. Knee Society function scores were not significantly associated with the radiographic variables assessed in this study. These findings may help guide clinician and patient expectations regarding improvement following TKA.