Higher satisfaction after total knee arthroplasty using restricted inverse kinematic alignment compared to adjusted mechanical alignment
Autor: | Thomas Tampere, Jonas Kellens, Kurt Claeys, Philip Winnock de Grave, Jacobus H. Müller, Paul Gunst, Thomas Luyckx |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Knee Joint Visual analogue scale medicine.medical_treatment Knee replacement Personal Satisfaction Inverse kinematic alignment Arthroplasty 03 medical and health sciences 0302 clinical medicine Patient satisfaction medicine Humans Robotic surgical procedures Orthopedics and Sports Medicine Arthroplasty Replacement Knee Varus deformity OUTCOMES 030222 orthopedics Science & Technology Patient-reported outcomes business.industry FEMORAL CONDYLE 030229 sport sciences Osteoarthritis Knee medicine.disease Biomechanical Phenomena Orthopedics Treatment Outcome VARUS Patient-specific alignment Orthopedic surgery Physical therapy Surgery Knee Prosthesis business Life Sciences & Biomedicine Body mass index Sport Sciences Oxford knee score |
Zdroj: | Knee Surgery, Sports Traumatology, Arthroscopy. 30:488-499 |
ISSN: | 1433-7347 0942-2056 |
Popis: | Purpose Various alignment philosophies for total knee arthroplasty (TKA) have been described, all striving to achieve excellent long-term implant survival and good functional outcomes. In recent years, in search of higher functionality and patient satisfaction, a shift towards more tailored and patient-specific alignment is seen. The purpose of this study was to describe a restricted ‘inverse kinematic alignment’ (iKA) technique, and to compare clinical outcomes of patients that underwent robotic-assisted TKA performed by restricted iKA vs. adjusted mechanical alignment (aMA). Methods The authors reviewed the records of a consecutive series of patients that received robotic-assisted TKA with restricted iKA (n = 40) and with aMA (n = 40). Oxford Knee Score (OKS) and satisfaction on a visual analogue scale (VAS) were collected at a follow-up of 12 months. Clinical outcomes were assessed according to patient acceptable symptom state (PASS) thresholds, and uni- and multivariable linear regression analyses were performed to determine associations of OKS and satisfaction with six variables (age, sex, body mass index (BMI), preoperative hip–knee–ankle (HKA) angle, preoperative OKS, alignment technique). Results The restricted iKA and aMA techniques yielded comparable outcome scores (p = 0.069), with OKS, respectively, 44.6 ± 3.5 and 42.2 ± 6.3. VAS Satisfaction was better (p = 0.012) with restricted iKA (9.2 ± 0.8) compared to aMA (8.5 ± 1.3). The number of patients that achieved OKS and satisfaction PASS thresholds was significantly higher (p = 0.049 and p = 0.003, respectively) using restricted iKA (98% and 80%) compared to aMA (85% and 48%). Knees with preoperative varus deformity, achieved significantly (p = 0.025) better OKS using restricted iKA (45.4 ± 2.0) compared to aMA (41.4 ± 6.8). Multivariable analyses confirmed better OKS (β = 3.1; p = 0.007) and satisfaction (β = 0.73; p = 0.005) with restricted iKA. Conclusions The results of this study suggest that restricted iKA and aMA grant comparable clinical outcomes at 12-month follow-up, though a greater proportion of knees operated by restricted iKA achieved the PASS thresholds for OKS and satisfaction. Notably. in knees with preoperative varus deformity, restricted iKA yielded significantly better OKS and satisfaction than aMA. Level of evidence Level III, comparative study. |
Databáze: | OpenAIRE |
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