The pre-anesthetic period is the best time to evaluate the knee flexion angle for predicting the flexion angle after total knee arthroplasty: A prospective cohort study.

<h4>Introduction</h4>Knee flexion angle (KFA) is one of the most critical factors for evaluating patient functional outcomes after total knee arthroplasty (TKA). Preoperative KFA and intraoperative drop leg test are both accepted as predictors of postoperative KFA after TKA. Preoperative...

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Main Authors: Pakpoom Ruangsomboon, Chaturong Pornrattanamaneewong, Polasan Santanapipatkul, Sorarid Sarirasririd, Keerati Chareancholvanich, Rapeepat Narkbunnam
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0281237
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author Pakpoom Ruangsomboon
Chaturong Pornrattanamaneewong
Polasan Santanapipatkul
Sorarid Sarirasririd
Keerati Chareancholvanich
Rapeepat Narkbunnam
author_facet Pakpoom Ruangsomboon
Chaturong Pornrattanamaneewong
Polasan Santanapipatkul
Sorarid Sarirasririd
Keerati Chareancholvanich
Rapeepat Narkbunnam
author_sort Pakpoom Ruangsomboon
collection DOAJ
description <h4>Introduction</h4>Knee flexion angle (KFA) is one of the most critical factors for evaluating patient functional outcomes after total knee arthroplasty (TKA). Preoperative KFA and intraoperative drop leg test are both accepted as predictors of postoperative KFA after TKA. Preoperative testing performed after anesthesia helps overcome pain-related limitations; however, the KFA measurement timepoint that best predicts KFA at 6 months after TKA has not yet been established.<h4>Methods</h4>This prospective cohort study recruited patients who underwent unilateral primary TKA at Siriraj Hospital (Bangkok, Thailand) during August 2012 to August 2017. We recorded KFA at the pre-anesthetic phase, post-anesthetic phase, intraoperation using drop leg test, and at 6-months post-operation. Pearson's correlation coefficient was used to evaluate correlation between different measurement timepoints and 6 months after surgery. Those same relationships were evaluated for overall patients, and for patients with KFA <90° (poor KFA), 90-120° (average KFA), and >120° (high KFA).<h4>Results</h4>A total of 165 patients with a mean age of 68.7 years were recruited. Pre-anesthetic KFA measurement had the highest positive correlation with the 6-month KFA (r = 0.771, p<0.05). Post-anesthetic measurement and intraoperative drop leg KFA measurement had moderate positive correlation (r = 0.561, p<0.05) and low positive correlation (r = 0.368, p<0.05) with the 6-month KFA, respectively. The average KFA group had the highest positive correlation between pre-anesthetic KFA measurement and the 6-month KFA (r = 0.711, p<0.05). Predicted 6-month KFA (degrees) adjusted for pre-anesthetic KFA is 45.378 + [0.596 x pre-anesthetic KFA (degrees)] (r = 0.67, p <0.05).<h4>Conclusions</h4>Pre-anesthetic KFA demonstrated the highest correlation with the final KFA at six months after unilateral primary TKA, especially in the patients who had a preoperative KFA within 90-120°.
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spelling doaj.art-652391a9f6314cb0b912b4deda0428fe2023-02-09T05:32:13ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01182e028123710.1371/journal.pone.0281237The pre-anesthetic period is the best time to evaluate the knee flexion angle for predicting the flexion angle after total knee arthroplasty: A prospective cohort study.Pakpoom RuangsomboonChaturong PornrattanamaneewongPolasan SantanapipatkulSorarid SarirasriridKeerati ChareancholvanichRapeepat Narkbunnam<h4>Introduction</h4>Knee flexion angle (KFA) is one of the most critical factors for evaluating patient functional outcomes after total knee arthroplasty (TKA). Preoperative KFA and intraoperative drop leg test are both accepted as predictors of postoperative KFA after TKA. Preoperative testing performed after anesthesia helps overcome pain-related limitations; however, the KFA measurement timepoint that best predicts KFA at 6 months after TKA has not yet been established.<h4>Methods</h4>This prospective cohort study recruited patients who underwent unilateral primary TKA at Siriraj Hospital (Bangkok, Thailand) during August 2012 to August 2017. We recorded KFA at the pre-anesthetic phase, post-anesthetic phase, intraoperation using drop leg test, and at 6-months post-operation. Pearson's correlation coefficient was used to evaluate correlation between different measurement timepoints and 6 months after surgery. Those same relationships were evaluated for overall patients, and for patients with KFA <90° (poor KFA), 90-120° (average KFA), and >120° (high KFA).<h4>Results</h4>A total of 165 patients with a mean age of 68.7 years were recruited. Pre-anesthetic KFA measurement had the highest positive correlation with the 6-month KFA (r = 0.771, p<0.05). Post-anesthetic measurement and intraoperative drop leg KFA measurement had moderate positive correlation (r = 0.561, p<0.05) and low positive correlation (r = 0.368, p<0.05) with the 6-month KFA, respectively. The average KFA group had the highest positive correlation between pre-anesthetic KFA measurement and the 6-month KFA (r = 0.711, p<0.05). Predicted 6-month KFA (degrees) adjusted for pre-anesthetic KFA is 45.378 + [0.596 x pre-anesthetic KFA (degrees)] (r = 0.67, p <0.05).<h4>Conclusions</h4>Pre-anesthetic KFA demonstrated the highest correlation with the final KFA at six months after unilateral primary TKA, especially in the patients who had a preoperative KFA within 90-120°.https://doi.org/10.1371/journal.pone.0281237
spellingShingle Pakpoom Ruangsomboon
Chaturong Pornrattanamaneewong
Polasan Santanapipatkul
Sorarid Sarirasririd
Keerati Chareancholvanich
Rapeepat Narkbunnam
The pre-anesthetic period is the best time to evaluate the knee flexion angle for predicting the flexion angle after total knee arthroplasty: A prospective cohort study.
PLoS ONE
title The pre-anesthetic period is the best time to evaluate the knee flexion angle for predicting the flexion angle after total knee arthroplasty: A prospective cohort study.
title_full The pre-anesthetic period is the best time to evaluate the knee flexion angle for predicting the flexion angle after total knee arthroplasty: A prospective cohort study.
title_fullStr The pre-anesthetic period is the best time to evaluate the knee flexion angle for predicting the flexion angle after total knee arthroplasty: A prospective cohort study.
title_full_unstemmed The pre-anesthetic period is the best time to evaluate the knee flexion angle for predicting the flexion angle after total knee arthroplasty: A prospective cohort study.
title_short The pre-anesthetic period is the best time to evaluate the knee flexion angle for predicting the flexion angle after total knee arthroplasty: A prospective cohort study.
title_sort pre anesthetic period is the best time to evaluate the knee flexion angle for predicting the flexion angle after total knee arthroplasty a prospective cohort study
url https://doi.org/10.1371/journal.pone.0281237
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