Minimum 5-year follow-up results and functional outcome of rotating-platform high-flexion total knee arthroplasty: A prospective study of 701 knees

Jain, Sanjeev; Pathak, Aditya C; Kalaivanan, K.

doi:10.1016/j.artd.2016.01.006

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…There are few studies that focus on kneeling ability as a primary outcome. Where kneeling has been evaluated, the percentage of patients able to comfortably kneel after TKA has varied greatly from 12% to 90% [7,8]. Patients who are unable to kneel have cited pain and discomfort, a lack of education on appropriate kneeling technique, and fear of harming their implant as reasons for refraining from kneeling [7].…”

Section: Introductionmentioning

confidence: 99%

Surgery-related predictors of kneeling ability following total knee arthroplasty: a systematic review and meta-analysis

Nadeem

Mundi

Chaudhry

2021

Knee Surg & Relat Res

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Purpose Kneeling ability is among the poorest outcomes following total knee arthroplasty (TKA). The purpose of this meta-analysis was to: (1) quantify kneeling ability after TKA; (2) identify surgical approaches and prosthesis designs that improve kneeling ability following TKA; and (3) quantify the effectiveness of these approaches. Methods We performed a systematic review in accordance with the PRISMA guidelines of multiple medical databases. Data relating to demographics, TKA technique, prosthesis design, and kneeling-specific outcomes were extracted. Comparative outcomes data were pooled using a random effects model. Results Thirty-six studies met the eligibility criteria. The proportion of patients able to kneel increased with longer follow-up (36.8% at a minimum of 1 year follow-up versus 47.6% after a minimum of 3 years follow-up, p < 0.001). The odds of kneeling were greater for patients undergoing an anterolateral incision compared with an anteromedial incision (OR 3.0, 95% CI 1.3–6.9, p = 0.02); a transverse incision compared with a longitudinal incision (OR 3.5, 95% CI 1.4–8.7, p = 0.008); and a shorter incision compared with a longer incision (OR 8.5, 95% CI 2.3–30.9, p = 0.001). The odds of kneeling were worse for a mobile prosthesis compared with a fixed platform design (OR 0.3, 95% CI 0.1–0.7, p = 0.005). Conclusion A large majority of patients are unable to kneel following TKA, although the ability to kneel improves over time. This evidence may facilitate preoperative patient counseling. Variations in choice of incision location and length may affect ability to kneel; however, high-quality randomized trials are needed to corroborate our findings.

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Section: Introductionmentioning

confidence: 99%

Surgery-related predictors of kneeling ability following total knee arthroplasty: a systematic review and meta-analysis

Nadeem

Mundi

Chaudhry

2021

Knee Surg & Relat Res

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“…TKA is the most common surgical procedure for the end-stage osteoarthritic knee [ 1 – 3 ]. The HKA angle representing the mechanical alignment that runs from the femoral head center to ankle center is expected to be adjusted toward neutral after TKA [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Association between changes in hip-knee-ankle angle and hindfoot alignment after total knee arthroplasty for varus knee osteoarthritis

Diao

Yang

et al. 2021

BMC Musculoskelet Disord

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Background The change in hip-knee-ankle (HKA) angle after total knee arthroplasty (TKA) may cause an adjustment in hindfoot alignment (HFA). However, the relationship between the changes in HKA angle and HFA is still not well studied. This study aimed to investigate the association between HKA angle and hindfoot alignment changes after TKA for varus knee osteoarthritis. Methods A prospective study was carried out in which 108 patients with varus knee deformities were radiographically and clinically evaluated before and 3 months after TKA. The relationship of change in HFA with correction in HKA angle was investigated. Results The results showed that the HFA was adjusted significantly by 3 months after TKA (p < 0.001), along with improved American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot score (p < 0.001). Next, a univariate correlation and linear regression analysis showed that the change in HFA was weakly correlated with the change in HKA angle (r=-0.262, β=-0.14, 95 % CI: -0.23 to -0.04, P = 0.006). Further stratified analysis and interaction tests revealed that age has a distinct effect on the correlation between the changes in HFA and HKA angle. The correlation was dramatically greater in the group under 65 years (r=-0.474, β=-0.26, 95 % CI: -0.41 to -0.12, P = 0.001), whilst, no correlation was observed in those above 65 years old (r=-0.036, β=-0.02, 95 % CI: -0.14 to 0.11, P = 0.779). Conclusions Our findings indicated that correction of HKA after TKA tend to promote adjustment in the hindfoot alignment toward re-balance of the whole lower limb weight-bearing axis. However, this mechanism obviously weakens in elderly patients. Therefore, if apparent hindfoot deformity exists in these patients before TKA, more perioperative intervention is required for hindfoot adjustment, and even HKA undercorrection may be considered.

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“…Background TKA is the most common surgical procedure for the end-stage osteoarthritic knee. [1][2][3] The HKA angle representing the mechanical alignment that runs from the femoral head center to ankle center is expected to be adjusted toward neutral after TKA. [4] However, the weight-bearing axis of the lower extremity that goes from pelvis to the ground including the hindfoot is drawing more and more attention, because it also determines the improvement of the clinical symptoms and long-term survival of the implant.…”

mentioning

confidence: 99%

Association Between Changes in Hip-knee-ankle Angle and Hindfoot Alignment After Total Knee Arthroplasty for Varus Knee Osteoarthritis

Diao

Yang

et al. 2021

Preprint

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Background: The change in hip-knee-ankle (HKA) angle after total knee arthroplasty (TKA) may cause an adjustment in hindfoot alignment (HFA). However, the relationship between the changes in HKA angle and HFA is still not well studied. This study aimed to investigate the association between HKA angle and hindfoot alignment changes after TKA for varus knee osteoarthritis.Methods: A prospective study was carried out in which 108 patients with varus knee deformities were radiographically and clinically evaluated before and 3 months after TKA. The relationship of change in HFA with correction in HKA angle was investigated.Results: The results showed that the HFA was adjusted significantly by 3 months after TKA (p < 0.001), along with improved American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot score (p < 0.001). Next, a univariate correlation and linear regression analysis showed that the change in HFA was weakly correlated with the change in HKA angle (r=-0.262, β=-0.14, 95% CI: -0.23 to -0.04, P=0.006). Further stratified analysis and interaction tests revealed that age has a distinct effect on the correlation between the changes in HFA and HKA angle. The correlation was dramatically greater in the group under 65 years (r=-0.474, β=-0.26, 95% CI: -0.41 to -0.12, P=0.001), whilst, no correlation was observed in those above 65 years old (r=-0.036, β=-0.02, 95% CI: -0.14 to 0.11, P=0.779). Conclusion: Our findings indicated that correction of HKA after TKA tend to promote adjustment in the hindfoot alignment toward re-balance of the whole lower limb weight-bearing axis. However, this mechanism obviously weakens in elderly patients. Therefore, if apparent hindfoot deformity exists in these patients before TKA, more perioperative intervention is required for hindfoot adjustment, and even HKA undercorrection may be considered.

show abstract

Minimum 5-year follow-up results and functional outcome of rotating-platform high-flexion total knee arthroplasty: A prospective study of 701 knees

Cited by 4 publications

References 21 publications

Surgery-related predictors of kneeling ability following total knee arthroplasty: a systematic review and meta-analysis

Surgery-related predictors of kneeling ability following total knee arthroplasty: a systematic review and meta-analysis

Association between changes in hip-knee-ankle angle and hindfoot alignment after total knee arthroplasty for varus knee osteoarthritis

Association Between Changes in Hip-knee-ankle Angle and Hindfoot Alignment After Total Knee Arthroplasty for Varus Knee Osteoarthritis

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