1. Radiographic severity, extent and pattern of cartilage loss are not associated with patient reported outcomes before or after total knee arthroplasty in end-stage knee osteoarthritis
- Author
-
Oisin J.F. Keenan, Nicholas D. Clement, Graham M. Lawson, Deborah MacDonald, George Holland, Lauren A. Ross, and Chloe E H Scott
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,Knee Joint ,Radiography ,Total knee arthroplasty ,Osteoarthritis ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Patient Reported Outcome Measures ,Prospective Studies ,030212 general & internal medicine ,Stage (cooking) ,Arthroplasty, Replacement, Knee ,Prospective cohort study ,Aged ,030203 arthritis & rheumatology ,business.industry ,Cartilage ,Mean age ,Osteoarthritis, Knee ,musculoskeletal system ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Female ,Full thickness ,business - Abstract
Background The aim of this study was to determine if radiographic severity, extent or pattern of knee osteoarthritis was associated with pain and function before total knee arthroplasty (TKA) or improvement therein one year after TKA. Methods A prospective study of 259 patients undergoing unilateral TKA for Kellgren-Lawrence (KL) grade ≥ 3 knee osteoarthritis was conducted: mean age 69.8 ± 9.7 (44–91); mean BMI 31.0 ± 5.8 (17–52); 152/259 (58.7%) female. Preoperative radiographs were assessed using the KL and Ahlback systems. Preoperatively and 1 year postoperatively patients completed Oxford Knee Scores, VAS-Pain and EQ-5D scores. Full thickness cartilage loss was recorded intraoperatively. Results Median radiographic severity was Ahlback 2, KL 4: 51/259 (19.7%) hypertrophic; 23/259 (8.8%) atrophic. Neither Ahlback nor Kellgren-Lawrence OA grade was associated with OKS, VAS Pain or EQ-5D prior to TKA (p > 0.05). The extent and pattern of cartilage loss did not affect preoperative PROMs. Radiographic OA severity, compartment involvement, and pattern of cartilage loss were not significantly associated with PROMs or improvements therein following TKA (p > 0.05). Hypertrophic OA was associated with less pain before TKA (difference 6.8, 0.23–13.9 95%CI, p = 0.044), and worse improvement in OKS following TKA (difference −3.41, −6.8 to −0.05 95%CI, p = 0.047). Better preoperative OKS and hypertrophic OA were independently associated with poorer improvement in OKS 1 year following TKA (R2 = 0.208). Conclusion Provided at least one compartment has KL grade ≥ 3 changes, further radiographic severity, pattern or extent of cartilage loss did not affect PROMs before or after TKA: multicompartmental was no worse than unicompartmental disease.
- Published
- 2021
- Full Text
- View/download PDF