FUNCTIONAL OUTCOME OF PATIENTS WITH MODERATE-TO-SEVERE OSTEOARTHRITIS TREATED BY TOTAL KNEE ARTHROPLASTY AT A TERTIARY CARE CENTER

Jaydeep Patil; Kapil Ghorpade; Shouryashil Khambalkar; Nagesh Naik; Tanish Patil

doi:10.22159/ajpcr.2023.v16i6.48291

Authors

Jaydeep Patil Department of Orthopaedics, Prakash Institute of Medical Sciences and Research, Urun Islampur, Maharashtra, India.
Kapil Ghorpade Department of Orthopaedics, Prakash Institute of Medical Sciences and Research, Urun Islampur, Maharashtra, India.
Shouryashil Khambalkar Department of Orthopaedics, Prakash Institute of Medical Sciences and Research, Urun Islampur, Maharashtra, India.
Nagesh Naik Department of Orthopaedics, Prakash Institute of Medical Sciences and Research, Urun Islampur, Maharashtra, India.
Tanish Patil Department of Orthopaedics, Prakash Institute of Medical Sciences and Research, Urun Islampur, Maharashtra, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i6.48291

Keywords:

Osteoarthritis knee, Arthroplasty, Functional Outcome, Complications

Abstract

Objectives: Osteoarthritis (OA) is one of the common causes of significant morbidity in elderly individuals. It typically manifests as painful joints affecting mobility in individuals particularly women in and after fifth or sixth decade of life. While most of the mild-to-moderate cases are managed conservatively, in severe OA total knee arthroplasty (TKA) is being increasingly done with good functional outcome. The aim of the study was to assess functional outcome in case knee OA cases treated by TKA. The study aimed to study the complication in patients undergoing TKA.

Methods: Forty patients with moderate-to-severe knee OA and treated by TKA were included in this study on the basis of a predefined inclusion and exclusion criteria. Demographic details such as gender and age were noted in all the cases. Body mass index (BMI) was determined. All patients were treated by TKA. Functional outcome was assessed by Japanese Orthopaedic Association score (JOA) as well as Functional knee clinical score (KCS). Incidence of complications was assessed during follow-up. For statistical purposes, p<0.05 was taken as significant.

Results: There were 25 (62.50%) females and 15 (37.50%) males with a M: F ratio of 1:1.66. 13 (32.50%) patients were obese (BMI≥30) and 16 (40.00%) patients were overweight (BMI≥25 but <30). A total of 11 (27.50%) patients had BMI <25. The mean KCS as well as JOA scores at the time of final follow-up were found to be significantly improved as compared to KCS and JOA scores at the time of presentation and the difference was found to be statistically highly significant (p<0.05). There was a significant reduction in pain as assessed by VAS score. Total 6 (15%) patients developed complication which could be managed conservatively.

Conclusion: TKA in patients with moderate-to-severe OA treated by TKA is associated with significant improvement in functional outcome and acceptable complication rate.

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References

Mora JC, Przkora R, Cruz-Almeida Y. Knee osteoarthritis: Pathophysiology and current treatment modalities. J Pain Res 2018;11:2189-96. doi: 10.2147/JPR.S154002, PMID: 30323653; PMCID: PMC6179584

Loeser RF. Age-related changes in the musculoskeletal system and the development of osteoarthritis. Clin Geriatr Med 2010;26:371-86. doi: 10.1016/j.cger.2010.03.002, PMID: 20699160; PMCID: PMC2920876

Magni A, Agostoni P, Bonezzi C, Massazza G, Menè P, Savarino V, et al. Management of osteoarthritis: Expert opinion on NSAIDs. Pain Ther 2021;10:783-808. doi: 10.1007/s40122-021-00260-1, PMID: 33876393; PMCID: PMC8586433

Hayashi D, Roemer FW, Guermazi A. Imaging of osteoarthritis-recent research developments and future perspective. Br J Radiol 2018;91:20170349. doi: 10.1259/bjr.20170349, PMID: 29271229; PMCID: PMC6190779

Wu ZX, Ren WX, Wang ZQ. Proximal fibular osteotomy versus high tibial osteotomy for treating knee osteoarthritis: A systematic review and meta-analysis. J Orthop Surg Res 2022;17:470. doi: 10.1186/ s13018-022-03299-8, PMID: 36307827; PMCID: PMC9617451

Zhang Y, Liu H. Safety of total knee arthroplasty in the treatment of knee osteoarthritis and its effect on postoperative pain and quality of life of patients. Contrast Media Mol Imaging 2021;2021:6951578. doi: 10.1155/2021/6951578, PMID: 35024014; PMCID: PMC8716239

Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the knee society clinical rating system. Clin Orthop Relat Res 1989;248:13-4. PMID: 2805470

Okuda M, Omokawa S, Okahashi K, Akahane M, Tanaka Y. Validity and reliability of the Japanese orthopaedic association score for osteoarthritic knees. J Orthop Sci 2012;17:750-6.

Muraki S, Akune T, Oka H, Ishimoto Y, Nagata K, Yoshida M, et al. Incidence and risk factors for radiographic knee osteoarthritis and knee pain in Japanese men and women: A longitudinal population-based cohort study. Arthritis Rheum 2012;64:1447-56. doi: 10.1002/ art.33508, PMID: 22135156

Bala K, Bavoria S, Sahni B, Bhagat P, Langeh S, Sobti S. Prevalence, risk factors, and health seeking behaviour for knee osteoarthritis among adult population in rural Jammu-a Community based Cross Sectional Study. J Family Med Prim Care 2020;9:5282-7. doi: 10.4103/jfmpc. jfmpc_643_20, PMID: 33409203; PMCID: PMC7773061

Andrianakos AA, Kontelis LK, Karamitsos DG, Aslanidis SI, Georgountzos AI, Kaziolas GO, et al. Prevalence of symptomatic knee, hand, and hip osteoarthritis in Greece. The ESORDIG study. J Rheumatol 2006;33:2507-13. PMID: 17143985

Losina E, Weinstein AM, Reichmann WM, Burbine SA, Solomon DH, Daigle ME, et al. Lifetime risk and age at diagnosis of symptomatic knee osteoarthritis in the US. Arthritis Care Res (Hoboken) 2013;65:703-11. doi: 10.1002/acr.21898, PMID: 23203864; PMCID: PMC3886119

Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Caspian J Intern Med 2011 Spring;2:205-12. PMID: 24024017; PMCID: PMC3766936

Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med 2010;26:355-69. doi: 10.1016/j.cger.2010.03.001. Erratum in: Clin Geriatr Med. 2013;29:ix. PMID: 20699159; PMCID: PMC2920533

Holmberg S, Thelin A, Thelin N. Knee osteoarthritis and body mass index: A population-based case-control study. Scand J Rheumatol 2005;34:59-64. doi: 10.1080/03009740510017922, PMID: 15903028

Singer SP, Dammerer D, Krismer M, Liebensteiner MC. Maximum lifetime body mass index is the appropriate predictor of knee and hip osteoarthritis. Arch Orthop Trauma Surg 2018;138:99-103. doi: 10.1007/ s00402-017-2825-5, PMID: 29079909; PMCID: PMC5754409

Gurler D. The influence of obesity on pain and function in knee osteoarthritis: Comparison of body mass index with seven knee function scales and two pain scales. Cureus 2022;14:e24304. doi: 10.7759/ cureus.24304, PMID: 35607585; PMCID: PMC9123411

Navaneeth PK, Prakash NS, Jose TM. Clinical and functional outcome of total knee arthroplasty in osteoarthritic patients at a tertiary care center in Kerala: A prospective study. Int J Adv Med 2022;9:1017-22.

Steinhaus ME, Christ AB, Cross MB. Total knee arthroplasty for knee osteoarthritis: Support for a foregone conclusion? HSS J 2017;13:207-10. doi: 10.1007/s11420-017-9558-4, PMID: 28690473; PMCID: PMC5481268

Skou ST, Roos EM, Laursen MB, Rathleff MS, Arendt-Nielsen L, Simonsen O, et al. A randomized, controlled trial of total knee replacement. N Engl J Med 2015;373:1597-606. doi: 10.1056/NEJMoa1505467, PMID: 26488691