Predictive Factors of 'Forgotten Knee' Acquisition After Total Knee Arthroplasty: Long-Term Follow-Up of a Large Prospective Cohort
| Autor: | Anaïs Charles-Nelson, Florent Eymard, Xavier Chevalier, Michel Bercovy, Sandrine Katsahian |
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| Rok vydání: | 2016 |
| Předmět: |
musculoskeletal diseases
Male medicine.medical_specialty Time Factors Knee Joint Joint Dislocations Pain Body Mass Index 03 medical and health sciences 0302 clinical medicine Medicine Humans Orthopedics and Sports Medicine Medical history Joint dislocation Postoperative Period Prospective Studies Range of Motion Articular Prospective cohort study Arthroplasty Replacement Knee Aged 030203 arthritis & rheumatology 030222 orthopedics Anthropometry business.industry Odds ratio Patella Middle Aged musculoskeletal system medicine.disease Confidence interval Surgery Orthopedics Treatment Outcome Orthopedic surgery Multivariate Analysis Female business Body mass index Follow-Up Studies |
| Zdroj: | The Journal of arthroplasty. 32(2) |
| ISSN: | 1532-8406 |
| Popis: | In a large prospective cohort, we recently showed that only 66.1% of total knee arthroplasty (TKA) with a perfect outcome according to Knee Society Knee Score was completely forgotten in all everyday activities. The main objective of this study was to identify clinical and orthopedic factors associated with the acquisition of "forgotten knee" (FK).Patients undergoing TKA were enrolled between January 2001 and January 2008. Preoperative medical history, anthropometric data, and clinical data were recorded, and composite scores (Knee Society Score, Lequesne) were assessed. Radiography was performed before and after surgery. At each follow-up, FK acquisition was assessed by a closed question "Does the operated knee feel always normal in all everyday activities?"We included 510 TKAs performed in 423 patients followed up for a mean of 76.6 ± 28.5 months. On multivariate analysis, depression at baseline and presence of patellar subluxation after surgery were negatively associated with FK acquisition (odds ratio [OR] = 0.28 [95% confidence interval {CI}, 0.13-0.61], P = .001; and OR = 0.31 [0.12-0.79], P = .01, respectively), whereas increased active flexion at last follow-up was positively associated (OR = 1.07 [1.03-1.10], P.0001). In patients with a perfect outcome (Knee Society Knee Score = 100), preoperative patellar pain, and postoperative patellar subluxation were negatively associated with FK acquisition (OR = 0.41 [0.18-0.93], P = .03 and OR = 0.21 [0.05-0.90], P = .04, respectively). Gender, age, body mass index, preoperative pain and functional limitation, and patellar resurfacing were not significantly related to FK.Depression and patella maltracking may be associated with lack of FK acquisition after TKA, while postoperative increase in flexion may have a positive impact. |
| Databáze: | OpenAIRE |
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