How are clinical outcomes related to the deviation severity of the tibiofemoral mechanical axis on coronal plane following knee arthroplasty?

Abstract

To analyze the effect of tibiofemoral mechanical axis (TFMA) deviation severity on clinical outcomes after total knee arthroplasty (TKA). Methods: We retrospectively reviewed the patients who underwent primary TKA between January 2002 and December 2010. After applying inclusion/exclusion criteria, we evaluated 70 knees of 51 patients. The mean AE SD follow-up period was 7.08 AE 1.34 years. The knees were divided into 3 groups based on TFMAs. The first group, identified as "well aligned," included the TFMAs that were neutral within 3 (0 AE 3 ) of alignment. The second group, identified as "outliers 1," included the slightly deviated TFMAs (À3 to À6 valgus and +3 to +6 varus). The third group, identified as "outliers 2," included the severely deviated TFMAs of more than 6 from neutral alignment (<À6 valgus and > + 6 varus). The clinical outcomes of each group were compared by evaluating the Oxford Knee Score (OKS), visual analog scale (VAS), and Short Form-36 physical component summary (SF-36 PCS) and mental component summary (SF-36 MCS) scores. Results: We found that OKS, SF-36 PCS, and SF-36 MCS were nearly the same in the well-aligned and outliers 1 groups but worse in the outliers 2 group. VAS scores were nearly the same in all groups. (p > 0.05) Conclusion: Function scores were impaired when the TFMA deviated more than 6 from neutral. However, the differences in clinical outcomes between well-aligned knees and those of outliers were not found to be statistically significant in the medium term.

Degree of Coronal Alignment Correction Can’t Predict Knee Function in Total Knee&nbsp;Replacement

“…In addition to the survival rate of prosthesis, many scholars paid attention to the relationship between coronal alignment and clinical outcomes(Table 1) [13][14][15][16][17][18][19][20][21][22][23][24][25]. But we think these studies have some limitations.…”

“…However, the relationship between alignment and knee function remains elusive (Table 1) [13][14][15][16][17][18][19][20][21][22][23][24][25]. Some research showed that residual varus leads to better [14,21] or similar [13,[17][18][19]23] clinical outcome for preoperative varus osteoarthritis.…”

Degree of coronal alignment correction can’t predict knee function in total knee replacement

“…With the improvement of modern implants and fixation techniques, many studies have confirmed the coronal alignment may not be as important a cause of failure as has been previously thought [ 4 , 5 ]. However, the relationship between alignment and knee function remains elusive (Table 1 ) [ 13 – 25 ]. Some research showed that residual varus leads to better [ 14 , 21 ] or similar [ 13 , 17 – 19 , 23 ] clinical outcome for preoperative varus osteoarthritis.…”

Degree of Coronal Alignment Correction Can’t Predict Knee Function in Total Knee Replacement

“…However, the relationship between alignment and knee function remains elusive (Table 1) [13][14][15][16][17][18][19][20][21][22][23][24][25].…”

“…[13][14][15][16][17][18][19][20][21][22][23][24][25]. But we think these studies have some limitations.…”