Thresholds for Oxford Knee Score after total knee replacement surgery: a novel approach to post-operative evaluation

Petersen, Christian Lund; Kjærsgaard, Jonas Bruun; Kjærgaard, Nicolai; Jensen, Michael Ulrich; Laursen, Mogens Berg

doi:10.1186/s13018-017-0592-1

Cited by 28 publications

(21 citation statements)

References 10 publications

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“…The PASS values we derived lie in the lower range of proposed cut-offs between 30 and 38 points for the OKS that previously have been suggested to reflect satisfaction with knee replacement (Judge et al 2012, Keurentjes et al 2014, Petersen et al 2017, Hamilton et al 2018. The variations in values from previous studies may be caused by differences in statistical methods, anchor questions used, and follow-up time-points.…”

Section: Discussionmentioning

confidence: 55%

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Which Oxford Knee Score level represents a satisfactory symptom state after undergoing a total knee replacement?

et al. 2020

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Background and purpose — Meaningful interpretation of postoperative Oxford Knee Score (OKS) levels is challenging. We established Patient Acceptable Symptoms State (PASS) and Treatment Failure (TF) values for the OKS in patients undergoing primary total knee replacement (TKR) in Denmark. Patients and methods — Data from patients undergoing primary TKR between February 2015 and January 2019 was extracted from the arthroplasty registry at the Copenhagen University Hospital, Hvidovre in Denmark. Data included 3, 12, and 24 months postoperative responses to the OKS and 2 anchor questions asking whether they considered their symptom state to be satisfactory, and if not, whether they considered the treatment to have failed. PASS and TF threshold values were calculated using the adjusted predictive modeling method. Non-parametric bootstrapping was used to derive 95% confidence intervals (CI). Results — Complete 3, 12, and 24 months postoperative data was obtained for 187 of 209 (89%), 884 of 915 (97%), and 575 of 586 (98%) patients, with median ages from 68 to 70 years (59 to 64% female). 72%, 77%, and 79% considered as having satisfactory symptoms, while 6%, 11%, and 11% considered the treatment to have failed, at 3, 12, and 24 months postoperatively, respectively. OKS PASS values (CI) were 27 (26–28), 30 (29–31), and 30 (29–31) at 3, 12, and 24 months postoperatively. TF values were 27 (26–28) and 27 (26–29) at 12 and 24 months postoperatively. Interpretation — The OKS PASS values can be used to guide the interpretation of TKR outcome and support quality assessment in institutional and national registries.

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Section: Discussionmentioning

confidence: 55%

“…VAS scales (range 0 to 100) (Judge et al 2012, Petersen et al 2017. A shortcoming of previous studies is therefore that the dichotomization thresholds are seemingly arbitrarily chosen.…”

Section: Discussionmentioning

confidence: 99%

Which Oxford Knee Score level represents a satisfactory symptom state after undergoing a total knee replacement?

et al. 2020

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“…In our study group, the mean VAS pain score was 2.2 (0 -6) and the average functional score on the WOMAC scale was 45 (range 32 -60), a moderately poor functional result [18]. The Oxford Knee Score -32.6 (range 27 -39) is also moderately poor functional result [19]. In recent papers, reported clinical outcomes after knee arthrodesis with modular and straight nails VAS score range 2.9-3, Oxford…”

Section: Discussionmentioning

confidence: 59%

Straight versus modular nail: Analysis of mechanical properties two knee arthrodesis methods.

Białecki¹,

Para²,

Sobolewski³

et al. 2020

Preprint

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Background Complications after arthroplasty often result in irreversible disability. In some cases for the extremity to be salvaged, the permanent knee joint arthrodesis is the last-chance procedure. Modular implant design simplifies surgical technique but modularity may potentially compromise mechanical strength of an implant. Mechanical properties of the implant are particularly important in case of knee arthrodesis without bone-on-bone contact where forces during gait and weight bearing are transmitted directly through the nail. The aim of this article was to perform comparative analysis of the mechanical properties of modular nail CHARFIX2 FN, when compared to the femoral nail, used for knee arthrodesis; and to analyze the effectiveness of treatment with use of this nail based on the observations of clinical cases. Methods Comparative analysis of: the static 4-point bending test, dynamic 4-point bending test and static torsion test. All tests were performed in accordance with requirements of ASTM F 1264. A clinical analysis of 5 cases, in which CHARFIX2 FN nails were used, was also performed. Results Based on the results of mechanical tests, the strength characteristics of CHARFIX2 FN nail have been found superior and more advantageous than corresponding features of the standard femoral nail. For CHARFIX2 FN nail, the median for flexural stiffness was almost 4 times higher and for maximum torque value was almost 2 times higher when compared to the femoral nail. Observations of the clinical cases gave satisfactory results. Conclusions The obtained mechanical tests present significant differences between CHARFIX2 FN and the femoral nail in mechanical strength and, therefore, its improved stability and safety for patients during walking. It can be used for permanent knee immobilization with satisfactory clinical results. The functional outcomes and subjective measurements of pain in patients treated with CHARFIX2 FN group are satisfying.

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“…All patients presented with handicapping pain, this was measured in the knee by the Oxford knee score, which had to be less than 20 and in the ankle by the Foot and Ankle Disability Index, which had to show at least 70% impairment. 11,12 Pain evaluation at rest and during activities was documented on a visual analog scale (VAS: 0-10) before and 12 months after the surgical procedures. Reduction of 50% in VAS score was considered clinically significant.…”

Section: Methodsmentioning

confidence: 99%

Chronic Knee and Ankle Pain Treatment through Selective Microsurgical Approaches: A Minimally Invasive Option in the Treatment Algorithm for Refractory Lower Limb Pain

Pietramaggiori

Sapino

Santis

et al. 2020

J Reconstr Microsurg

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Background Injury or compression of a sensory nerve is an under-reported source of disabling pain in the lower limb. It is known that peripheral nerve microsurgeons can reconstruct and rewire injured nerves to relieve chronic pain but this option remains not completely understood and ignored by most orthopaedic surgeons, neurologists, and pain therapists. In this paper, we describe our experience with knee and ankle peripheral nerve surgery to improve the condition of patients suffering from chronic, posttraumatic lower limb pain. Patients and Methods Between 2015 and 2018, a retrospective investigation was performed including patients who underwent ankle and knee nerve surgery for posttraumatic chronic pain with at least 1 year of follow-up. Previous surgeries or type of trauma, pain location and characteristics, type of operation (reconstruction, decompression, or denervation), and number of nerves operated were listed. Selective neuropathy was confirmed by ultrasound-guided nerve blocks. Outcome was assessed combining the visual analogue scale (VAS) score at rest and during movement, functional indexes, drug use, and ability to work. Results A total of 34 patients (14 knee and 20 ankle) were included in this study. A statistically significant difference (p < 0.05%) in postoperative pain at rest and during activity was seen in both groups of patients. Good to excellent outcomes were recorded in 92 and 80% of patients treated, respectively, at the knee and the ankle levels. No major complications occurred, while a secondary procedure due to neuroma recurrence was necessary in seven patients (three knees and four ankles). Conclusion Peripheral nerve microsurgery is a useful and minimally invasive tool to be added in the algorithm of treatment of chronic knee and ankle pain. Physicians should be trained to suspect a neuropathic origin of pain in absence of musculoskeletal signs of pathology, especially following trauma or surgeries.

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Thresholds for Oxford Knee Score after total knee replacement surgery: a novel approach to post-operative evaluation

Cited by 28 publications

References 10 publications

Which Oxford Knee Score level represents a satisfactory symptom state after undergoing a total knee replacement?

Which Oxford Knee Score level represents a satisfactory symptom state after undergoing a total knee replacement?

Straight versus modular nail: Analysis of mechanical properties two knee arthrodesis methods.

Chronic Knee and Ankle Pain Treatment through Selective Microsurgical Approaches: A Minimally Invasive Option in the Treatment Algorithm for Refractory Lower Limb Pain

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