Variation in ligamentous laxity in well-functioning total knee arthroplasty is not associated with clinical outcomes or functional ability

Autor: Colin R. Howie, Richard Burnett, Daniel Mandziak, Alexandria Sehgal, David F. Hamilton
Rok vydání: 2020
Předmět:
musculoskeletal diseases
Male
Ligamentous laxity
medicine.medical_specialty
Knee Joint
Revision total knee arthroplasty
medicine.medical_treatment
Patient satisfaction
Clinical outcomes
Instability
Revision total knee arthroplasty
Clinical outcomes
Functional assessment
medicine
Humans
Orthopedics and Sports Medicine
Muscle Strength
Patient Reported Outcome Measures
Prospective Studies
Functional ability
Range of Motion
Articular
Arthroplasty
Replacement
Knee
Aged
Aged
80 and over
business.industry
Instability
Middle Aged
musculoskeletal system
medicine.disease
Arthroplasty
Stair Climbing
Sagittal plane
Treatment Outcome
medicine.anatomical_structure
Patient Satisfaction
Coronal plane
Ligaments
Articular
Physical therapy
Female
Original Article
Surgery
Functional assessment
Range of motion
business
human activities
Oxford knee score
Follow-Up Studies
Zdroj: European Journal of Orthopaedic Surgery & Traumatology
ISSN: 1432-1068
1633-8065
DOI: 10.1007/s00590-020-02634-1
Popis: Background Around 20% of revision knee arthroplasty procedures are carried out for a diagnosis of instability. Clinical evaluation of instability is primarily through physical stress testing of knee ligamentous laxity and joint space opening. It is assumed that increased knee ligament laxity is associated with instability of the knee and, by association, reduced physical function. The range of knee ligament laxity in asymptomatic patients with total knee arthroplasty has however not been reported, nor has the association with measures of physical outcomes. Methods Patients who reported being happy with the outcomes of TKA and denied any feelings of knee instability were evaluated at routine follow-up clinicas. Knee ligamentous stability was evaluated seperately by 2 blinded assessors in both coronal and saggital planes. Assessors classified the ligamentous stability as ‘tight’, ‘neutrol’ or ‘loose’. Clinical outcome was evaluated by Oxford Knee Score, patient satisfaction metric, timed performance test, range of motion and lower limb power. Analysis of variance was employed to evaluate variables between groups with post hoc pairwise comparisons. Results In total, 42 patients were evaluated. Mean time since index surgery was 46 (SD 8) months. In the coronal plane, 11 (26.2%) were categorised as ‘tight’, 22 (52.4%) as ‘neutral’ and 9 (21.4%) as ‘loose’. In the sagittal plane, 15 (35.7%) were categorised as ‘tight’, 17 (40.5%) as ‘neutral’ and 10 (23.8%) as ‘loose’. There were no between-group differences in outcomes: Oxford Knee Score, range of motion, lower limb power, timed functional assessment score or in satisfaction response in either plane (p = 0.05). Conclusions We found a range of ligamentous laxity in asymptomatic patients satisfied with the outcome of their knee arthroplasty, and no association between knee laxity and physical ability.
Databáze: OpenAIRE
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