Severity and location of lumbar spine stenosis affects the outcome of total knee arthroplasty

Autor: William L. Sheppard, Kevin M. McKay, Alexander Upfill-Brown, Gideon Blumstein, Howard Y. Park, Akash Shah, Adam A. Sassoon, Don Y. Park
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Journal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-7 (2021)
Druh dokumentu: article
ISSN: 1749-799X
DOI: 10.1186/s13018-021-02864-x
Popis: Abstract Background Recent studies have noted that patients with pre-existing lumbar spinal stenosis (LSS) have lower functional outcomes after total knee arthroplasty (TKA). Given that LSS manifests heterogeneously in location and severity, its influence on knee replacement merits a radiographically targeted analysis. We hypothesize that patients with more severe LSS will have diminished knee mobility before and after TKA. Methods This retrospective case series assessed all TKAs performed at our institution for primary osteoarthritis from 2017–2020. Preoperative lumbar magnetic resonance image (MRI) with no prior lumbar spine surgery was necessary for inclusion. Stenosis severity was demonstrated by (1) anterior–posterior (AP) diameter of the thecal sac and (2) morphological grade. TKA outcomes in 103 cases (94 patients) were assessed by measuring preoperative and postoperative arc of motion (AOM), postoperative flexion contracture, and need for manipulation under anesthesia. Results Patients with mild stenosis did significantly better in terms of postoperative knee AOM. As AP diameter decreased at levels L1–2, L2–3, L3–4, and L4–5, there was a significant reduction in preoperative-AOM (p
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