Abstract
BackgroundIt is not established beyond doubt whether improvements in functional outcome after total knee arthroplasty (TKA) are maintained in the long term. We therefore investigated the temporal patterns of functional outcome [using range of motion (ROM), American Knee Society (AKS) score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, and 36-Item Short Form Health Survey (SF-36) score] over a 5-year period after uncomplicated TKA, and whether these patterns differed by implant type and patient age.Materials and methodsThis prospective study evaluated 138 patients who underwent unilateral TKA with either a mobile-bearing (MB) or fixed-bearing (FB) posterior-stabilized prosthesis. An independent investigator evaluated the functional outcome at five time points: preoperatively and at 6-month, 1-year, 2-year, and 5-year follow-up. Differences in functional outcomes between adjacent time points were evaluated by mixed-effect model repeat measurement (MMRM).ResultsThe different functional outcome scores showed improvement till 6 months–2 years, followed by a variable decline. In patients aged ≥ 68 years with an MB implant, most of the functional outcome scores declined between 2 and 5 years after variable initial improvement till 6 months–2 years, whereas the parameters plateaued after 2 years in those aged < 68 years and in older patients with an FB implant.ConclusionsA decline in function and pain relief occurs 2 years after TKA. This decline is more evident in older patients with an MB prosthesis. Based on these findings, we believe that use of MB implants in older patients (≥ 68 years) requires further investigation.Level of evidenceLevel 3.
Highlights
Evidence-based knowledge about the temporal pattern of functional results after total knee arthroplasty (TKA) has far-reaching clinical implications
The aims of this study are: (1) to investigate the temporal patterns of functional outcomes [using range of motion (ROM), American Knee Society Score [AKS], Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, and 36-Item Short Form Health Survey (SF-36) score] over a 5-year period after uncomplicated TKA, and (2) to determine whether the temporal patterns of functional outcome after TKA differ by implant type and patient age
The mean SF-36 physical component summary (PCS) score improved from baseline until 1 year and was constant until 2 years, before showing a decline at 5 years (Fig. 2g)
Summary
Evidence-based knowledge about the temporal pattern of functional results after total knee arthroplasty (TKA) has far-reaching clinical implications. Long-term follow-up studies after TKA have shown survival rates of up to 97% at 15 and 20 years [1, 2]. Survival rates provide important information to physicians and patients; it is important to know how well the knee will. It is not established beyond doubt whether improvements in functional outcome after total knee arthroplasty (TKA) are maintained in the long term. We investigated the temporal patterns of functional outcome [using range of motion (ROM), American Knee Society (AKS) score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, and 36-Item Short Form Health Survey (SF-36) score] over a 5-year period after uncomplicated TKA, and whether these patterns differed by implant type and patient age
Sign-in/Register to view highlights & summary 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.
