Abstract
Aim of the studyTo determine if pre-operative radiologic minimal joint space width (mJSW) is related to the outcome of total knee arthroplasty (TKA) (primary hypothesis). Likewise, the aim was to test if pre-operative mJSW is related to prosthesis survival (secondary hypothesis).MethodsA retrospective comparative analysis was performed. Group 1 was comprised of patients with pre-operative mJSW 0–1 mm. Group 2 were patients with pre-operative mJSW ≥ 2 mm. The clinical outcome was determined with the Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC) score pre-operatively and one year after TKA. Only patients with pre-operative weight-bearing radiographs and complete WOMAC score data were accepted.ResultsAvailable for analysis were 377 patients, of whom 188 were allocated to Group 1 (118 female, 70 male, age 70 ± 11 years) and 189 to Group 2 (118 female, 71 male, age 70 ± 13 years). Pre-operative WOMAC total and WOMAC subscores showed no significant differences between groups. Post-operatively, the WOMAC total was significantly better in Group 1 than in Group 2, 10 ± 22 and 19 ± 31, respectively (p < 0.001, Power 97.5%). Similarly, the WOMAC subscores for pain, stiffness, and function were also significantly better in Group 1 than in Group 2. Five-year prosthesis survival was 94.2 and 91.6% in Groups 1 and 2, respectively (p = 0.07, Power 71%).DiscussionPatients with pre-operative complete joint space collapse (0 to 1 mm mJSW) achieve a significantly better WOMAC result from TKA than do those with a mJSW equal to or greater than 2 mm. From our findings, it is recommended that “complete joint space collapse” especially be used as an indication for TKA surgery.ConclusionOur study was underpowered to sufficiently show an effect of pre-operative mJSW on prosthesis survival.
Highlights
Up to 30% of patients were reported to not be satisfied with the outcome of total knee arthroplasty because of unexplained pain (TKA) [1,2,3,4,5]
Merle-Vincent et al investigated the influence of preoperative severity of knee OA on patient satisfaction after TKA in 264 cases [8]
Pre-operative Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC) total and WOMAC subscores showed no significant differences between Group 1 and Group 2 (Table 1)
Summary
Up to 30% of patients were reported to not be satisfied with the outcome of total knee arthroplasty because of unexplained pain (TKA) [1,2,3,4,5]. Among other patient-related factors, the severity of knee osteoarthritis (OA) (e.g. joint space width) is of obvious importance. Merle-Vincent et al investigated the influence of preoperative severity of knee OA on patient satisfaction after TKA in 264 cases [8]. They reported that patients with preoperative more severe joint space narrowing were more likely to be satisfied two years post-operative. Five other studies investigated the relationship between severity of knee OA and International Orthopaedics (SICOT) (2019) 43:1841–1847
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
