The effect of preoperative symptom severity on functional outcome of total knee replacement--patients with the lowest preoperative scores achieve the lowest marks

The Knee
J T K LimS White

Abstract

To determine if the functional outcome of total knee replacement (TKR) was affected by the level of preoperative symptom severity, the association between preoperative Oxford Knee Scores (OKS), and 2 year OKS, American Knee Society clinical and function scores (AKSS) was assessed. Data were prospectively collected on 45 cases who had single joint osteoarthritis and no other comorbidities. We have specifically focused on patients with single knee involvement to remove the effect of multiple joint involvement and comorbidities on the OKS. The mean preoperative OKS was 21.4, postoperative OKS 40.0 and postoperative ROM 117 degrees. The postoperative mean AKSS was 86.7 and mean function score was 85.0. The 'usual pain' and 'limp' components of the OKS had the greatest rises and the 'kneel' component had the least improvement. Rather than all patients achieving uniform results post-TKR, patients with more severe symptoms achieved poorer absolute outcomes. The Spearman correlation coefficient between pre- and postoperative OKS was r = 0.4 (p = 0.006). Although the results suggest that waiting too long before intervention compromises the final outcome, a correlation of 0.4 is not strong enough to necessitate change in current practice.

References

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Citations

Oct 15, 2009·International Orthopaedics·Urs K MunzingerTomas Drobny
Jan 10, 2008·Archives of Orthopaedic and Trauma Surgery·Jill DawsonAndrew Carr
Mar 25, 2008·The Journal of Arthroplasty·Merrill A RitterJohn B Meding
Dec 2, 2011·Journal of Evaluation in Clinical Practice·Kari TirkkonenPetri Virolainen
Jan 7, 2011·The Journal of Bone and Joint Surgery. American Volume·Joseph F StyronMendel E Singer
Aug 30, 2008·Clinical Orthopaedics and Related Research·Stephanie Y Pun, Michael D Ries
Dec 2, 2009·The Journal of Bone and Joint Surgery. British Volume·I StarksS H White
Sep 6, 2007·The Journal of Bone and Joint Surgery. British Volume·D W MurrayJ Dawson
Jan 12, 2013·The Bone & Joint Journal·D P WilliamsR E Field
Oct 1, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Jia Long ChuaSeng-Jin Yeo
Sep 1, 2015·Journal of Orthopaedic Surgery·J Bt LimN N Lo
Jan 31, 2021·Archives of Orthopaedic and Trauma Surgery·Kilian RuecklFriedrich Boettner

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