Patient-Reported Outcome and Survivorship After Kinemax Total Knee Arthroplasty

Background TKA is commonly performed to treat advanced inflammatory and degenerative knee arthritis. With increasing use in younger patients, it is important to define the best practices to enhance clinical performance and implant longevity. Questions/purposes We systematically reviewed the literature to assess: (1) how TKAs perform in young patients; (2) whether the TKA is a durable procedure for young patients, and (3) what guidance the literature outlines for TKA in young patients. Methods We searched the literature between 1950 and 2009 for all studies reporting on TKAs for patients younger than 55 years that documented clinical and radiographic assessments with a minimum 2-year followup. Thirteen studies, reporting on 908 TKAs performed for 671 patients, met these criteria. Results Mean Knee Society clinical and functional scores increased by 47 and 37 points, respectively. Implant survivorship was reported between 90.6% and 99% during the first decade and between 85% and 96.5% during the second decade of followup. The literature does not direct specific techniques for TKA for young patients.Conclusions TKA provides surgeon-measured clinical and functional improvements with a moderate increase in second-decade implant failures.

Section: Discussionsupporting

confidence: 77%

What is the Evidence for Total Knee Arthroplasty in Young Patients?: A Systematic Review of the Literature

Keeney

Eunice

Pashos

et al. 2011

“…Therefore, particular attention was paid to the pain and function components of WOMAC scores and the bodily pain and physical function components of the SF-36 scores. Scores for WOMAC pain and function domains were transformed to a 0 to 100 scale [21,23], with 0 indicating extreme pain/functional disability and 100 indicating no pain/functional disability. Because the primary aim of the study was to explore the effect of surgery on pain and function, only the bodily pain (BP) and physical function (PF) components of the SF-36 scores, with scores ranging from 0 to 100 with 100 being best, were included in the final analysis [20].…”

Section: Methodsmentioning

confidence: 99%

When Do Patient-reported Assessments Peak after Revision Knee Arthroplasty?

Malviya

Bettinson

Kurtz

et al. 2012

Background The best timing for patient visits after revision TKA is unclear. Predictors of pain and function reported in the literature typically look at the influence at a given time that might not be ideal if the score is not at a peak or the earliest possible time. Moreover, most reports of predictors include revisions for infection, which typically have a poorer outcome, or for other indications with variable outcome.Questions/purposes We therefore determined (1) the trend of recovery after revision TKA to determine the best time to measure the peak patient-reported pain and function scores and (2) the influence of comorbidities and age on the patterns of recovery. Methods We prospectively followed 120 patients who had revision TKAs from 2003 to 2008. The patients were assessed within 6 weeks before surgery and at 12 weeks, 1 year, and annually thereafter. We obtained WOMAC and SF-36 scores at each visit. We used a linear mixed model analysis to assess predictors. The minimum followup was 2 years (mean, 3 years; range, 2-7 years). Results The majority of improvements in the WOMAC and SF-36 scores occurred during the first year after surgery after which the scores stabilized. One of the seven independent preoperative variables studied (comorbidities) predicted a trend toward improvement of WOMAC pain, WOMAC function, and SF-36 bodily pain scores. The greater the numbers of comorbidities, the worse were the scores. Age, gender, BMI, indication for surgery, and surgeon did not independently influence the WOMAC or SF-36. Conclusion Our data suggest that one of the times for patient visits after revision TKA should be 1 year after surgery. This time allows for key discrimination of implant performance.

“…Only one-third of patients report no functional problems with the surgical knee [56] and approximately 20% report dissatisfaction with their functional ability 1 year or more after surgery [24]. Functional deficits after surgery affect many activities with as much as 40% of patients still requiring the use of an assistive device to ambulate [18].…”

Section: Introductionmentioning

confidence: 99%

Preoperative Pain Catastrophizing Predicts Pain Outcome after Knee Arthroplasty

Riddle

Wade

Jiranek

et al. 2010

343

296

Psychologic status is associated with poor outcome after knee arthroplasty yet little is known about which specific psychologic disorders or pain-related beliefs contribute to poor outcome. To enhance the therapeutic effect of a psychologic intervention, the specific disorders or pain-related beliefs that contributed to poor outcome should be identified. We therefore determined whether specific psychologic disorders (ie, depression, generalized anxiety disorder, panic disorder) or health-related beliefs