Temporal patterns of commonly used clinical outcome scales during a 5-year period after total knee arthroplasty

Abstract Background It is not established beyond doubt whether improvements in functional outcome after total knee arthroplasty (TKA) are maintained in the long term. We therefore investigated the temporal patterns of functional outcome [using range of motion (ROM), American Knee Society (AKS) score...

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Main Authors: Vivek Tiwari, Jonggeun Lee, Gaurav Sharma, Yeon Gwi Kang, Tae Kyun Kim
Format: Article
Language:English
Published: SpringerOpen 2019-03-01
Series:Journal of Orthopaedics and Traumatology
Subjects:
Online Access:http://link.springer.com/article/10.1186/s10195-019-0520-8
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author Vivek Tiwari
Jonggeun Lee
Gaurav Sharma
Yeon Gwi Kang
Tae Kyun Kim
author_facet Vivek Tiwari
Jonggeun Lee
Gaurav Sharma
Yeon Gwi Kang
Tae Kyun Kim
author_sort Vivek Tiwari
collection DOAJ
description Abstract Background It is not established beyond doubt whether improvements in functional outcome after total knee arthroplasty (TKA) are maintained in the long term. We therefore investigated the temporal patterns of functional outcome [using range of motion (ROM), American Knee Society (AKS) score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, and 36-Item Short Form Health Survey (SF-36) score] over a 5-year period after uncomplicated TKA, and whether these patterns differed by implant type and patient age. Materials and methods This prospective study evaluated 138 patients who underwent unilateral TKA with either a mobile-bearing (MB) or fixed-bearing (FB) posterior-stabilized prosthesis. An independent investigator evaluated the functional outcome at five time points: preoperatively and at 6-month, 1-year, 2-year, and 5-year follow-up. Differences in functional outcomes between adjacent time points were evaluated by mixed-effect model repeat measurement (MMRM). Results The different functional outcome scores showed improvement till 6 months–2 years, followed by a variable decline. In patients aged ≥ 68 years with an MB implant, most of the functional outcome scores declined between 2 and 5 years after variable initial improvement till 6 months–2 years, whereas the parameters plateaued after 2 years in those aged < 68 years and in older patients with an FB implant. Conclusions A decline in function and pain relief occurs 2 years after TKA. This decline is more evident in older patients with an MB prosthesis. Based on these findings, we believe that use of MB implants in older patients (≥ 68 years) requires further investigation. Level of evidence Level 3.
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spelling doaj.art-765c29e9879444a4b5714512c5a8c66c2022-12-22T04:14:17ZengSpringerOpenJournal of Orthopaedics and Traumatology1590-99211590-99992019-03-0120111010.1186/s10195-019-0520-8Temporal patterns of commonly used clinical outcome scales during a 5-year period after total knee arthroplastyVivek Tiwari0Jonggeun Lee1Gaurav Sharma2Yeon Gwi Kang3Tae Kyun Kim4Joint Reconstruction Center, Seoul National University Bundang HospitalJoint Reconstruction Center, Seoul National University Bundang HospitalJoint Reconstruction Center, Seoul National University Bundang HospitalJoint Reconstruction Center, Seoul National University Bundang HospitalJoint Reconstruction Center, Seoul National University Bundang HospitalAbstract Background It is not established beyond doubt whether improvements in functional outcome after total knee arthroplasty (TKA) are maintained in the long term. We therefore investigated the temporal patterns of functional outcome [using range of motion (ROM), American Knee Society (AKS) score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, and 36-Item Short Form Health Survey (SF-36) score] over a 5-year period after uncomplicated TKA, and whether these patterns differed by implant type and patient age. Materials and methods This prospective study evaluated 138 patients who underwent unilateral TKA with either a mobile-bearing (MB) or fixed-bearing (FB) posterior-stabilized prosthesis. An independent investigator evaluated the functional outcome at five time points: preoperatively and at 6-month, 1-year, 2-year, and 5-year follow-up. Differences in functional outcomes between adjacent time points were evaluated by mixed-effect model repeat measurement (MMRM). Results The different functional outcome scores showed improvement till 6 months–2 years, followed by a variable decline. In patients aged ≥ 68 years with an MB implant, most of the functional outcome scores declined between 2 and 5 years after variable initial improvement till 6 months–2 years, whereas the parameters plateaued after 2 years in those aged < 68 years and in older patients with an FB implant. Conclusions A decline in function and pain relief occurs 2 years after TKA. This decline is more evident in older patients with an MB prosthesis. Based on these findings, we believe that use of MB implants in older patients (≥ 68 years) requires further investigation. Level of evidence Level 3.http://link.springer.com/article/10.1186/s10195-019-0520-8Total knee arthroplastyFunctional outcomePatternAgeProsthesis
spellingShingle Vivek Tiwari
Jonggeun Lee
Gaurav Sharma
Yeon Gwi Kang
Tae Kyun Kim
Temporal patterns of commonly used clinical outcome scales during a 5-year period after total knee arthroplasty
Journal of Orthopaedics and Traumatology
Total knee arthroplasty
Functional outcome
Pattern
Age
Prosthesis
title Temporal patterns of commonly used clinical outcome scales during a 5-year period after total knee arthroplasty
title_full Temporal patterns of commonly used clinical outcome scales during a 5-year period after total knee arthroplasty
title_fullStr Temporal patterns of commonly used clinical outcome scales during a 5-year period after total knee arthroplasty
title_full_unstemmed Temporal patterns of commonly used clinical outcome scales during a 5-year period after total knee arthroplasty
title_short Temporal patterns of commonly used clinical outcome scales during a 5-year period after total knee arthroplasty
title_sort temporal patterns of commonly used clinical outcome scales during a 5 year period after total knee arthroplasty
topic Total knee arthroplasty
Functional outcome
Pattern
Age
Prosthesis
url http://link.springer.com/article/10.1186/s10195-019-0520-8
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