Predicting dissatisfaction following total knee arthroplasty in patients under 55 years of age

Scott, Chloe E H; Oliver, William W.; MacDonald, Deborah J.; Wade, F A; Moran, Matthew D.; Breusch, Steffen

doi:10.1302/0301-620x.98b12.bjj-2016-0375.r1

Cited by 130 publications

(87 citation statements)

References 35 publications

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“…1 In particular, this is a more serious problem for young patients, for whom an early revision is not only a major setback in the short term, but a serious threat to the long-term function of the limb. 2 Instability and stiffness are directly related to the position, size and geometry of the components, and with tension in the ligaments throughout the motion arc.…”

Section: Introductionmentioning

confidence: 99%

Optimising position and stability in total knee arthroplasty

Victor

2017

EFORT Open Reviews

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Alignment and stability are two key factors for success in total knee arthroplasty (TKA). Several techniques have been advocated, the two best known being measured resection and tensioned gaps.Dogma and fuzzy wording have cast an obscure shadow on the dualistic discussion between proponents of both techniques.This review is an attempt to clarify definitions, analyse the flaws and pitfalls in the different techniques and make some suggestions for improvement.Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.170001. Originally published online at www.efortopenreviews.org

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Section: Introductionmentioning

confidence: 99%

Optimising position and stability in total knee arthroplasty

Victor

2017

EFORT Open Reviews

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“…Studies have shown that patients with less severe (radiographic) osteoarthritis have worse TKA outcomes than those with greater severity . However, radiographic grading systems used to determine disease severity are crude and are not necessarily correlated with symptom severity Box 1.…”

Section: Patient Characteristics Influencing Decision Makingmentioning

confidence: 99%

Selecting and optimising patients for total knee arthroplasty

Adie

Harris

Chuan

et al. 2019

Medical Journal of Australia

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Summary The minimum requirements for total knee arthroplasty (TKA) are significant, prolonged symptoms with supporting clinical and radiological signs. Despite interest in screening tools, there is limited evidence for a specific symptom threshold that justifies surgery. Non‐operative treatments including medications, exercise and weight loss are unlikely to reverse radiographic changes, but they may improve symptoms and delay the need for surgery. Many patient factors such as mental health and obesity affect both the level of symptomatic improvement after surgery and risks of surgery, but none have been identified as contraindications for the procedure as significant health gains can still be achieved. Although age and sex are associated with patient‐reported outcomes and risk of revision, these factors cannot be used to restrict access to TKA, and age cut‐offs are not recommended. Evidence regarding pre‐operative optimisation of patients to improve post‐operative TKA outcomes is limited by the few interventional trials available, particularly in the areas of patient expectation, diabetes, obesity and vascular disease. There is good evidence from randomised controlled trials that pre‐operative rehabilitation primarily focusing on exercises for the joint or limb has minimal effect on post‐operative TKA outcomes, and there is some evidence from randomised controlled trials that an intensive smoking cessation program before surgery may improve post‐operative outcomes. Detailed international guidelines exist on the optimisation of the cardiorespiratory status of surgical patients, and these should be followed for TKA surgery.

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“…In the current study, younger age was a significant predictor of expectation fulfillment in the long-term. Previous studies have noted that younger patients (<65 years) tend to have lower levels of satisfaction, despite excellent PROMs scores, up to 1 year following TKA [28,29]. Witjes et al [30] identified that younger patients tended to have expectations to perform multiple activities better following TKA, and that no commonly utilized PROM scoring systems adequately covered all that were considered important.…”

Section: Percentage Of Pa Ents Sta Ng This Expecta On Was Important Pmentioning

confidence: 99%

Changes in Expectation Fulfillment Following Total Knee Arthroplasty: A 10-Year Follow-Up Study

Yapp

Clement

MacDonald

et al. 2020

The Journal of Arthroplasty

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Predicting dissatisfaction following total knee arthroplasty in patients under 55 years of age

Abstract: Patients receiving TKA younger than 55 years old should be informed about the increased risks of dissatisfaction. Offering TKA in KL 1/2 is questionable, with a dissatisfaction rate of 59%. Cite this article: Bone Joint J 2016;98-B:1625-34.

Cited by 130 publications

References 35 publications

Optimising position and stability in total knee arthroplasty

Optimising position and stability in total knee arthroplasty

Selecting and optimising patients for total knee arthroplasty

Changes in Expectation Fulfillment Following Total Knee Arthroplasty: A 10-Year Follow-Up Study

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