N D Clement1, D J MacDonald2, D F Hamilton2, R Burnett3. 1. Department of Orthopaedics, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, EH16 4SA, UK nickclement@doctors.org.uk. 2. Department of Orthopaedics, University of Edinburgh, FU413, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH164SB, UK. 3. Department of Orthopaedics, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, EH16 4SA, UK.
Abstract
OBJECTIVES: Preservation of posterior condylar offset (PCO) has been shown to correlate with improved functional results after primary total knee arthroplasty (TKA). Whether this is also the case for revision TKA, remains unknown. The aim of this study was to assess the independent effect of PCO on early functional outcome after revision TKA. METHODS: A total of 107 consecutive aseptic revision TKAs were performed by a single surgeon during an eight-year period. The mean age was 69.4 years (39 to 85) and there were 59 female patients and 48 male patients. The Oxford Knee Score (OKS) and Short-form (SF)-12 score were assessed pre-operatively and one year post-operatively. Patient satisfaction was also assessed at one year. Joint line and PCO were assessed radiographically at one year. RESULTS: There was a significant improvement in the OKS (10.6 points, 95% confidence interval (CI) 8.8 to 12.3) and the SF-12 physical component score (5.9, 95% CI 4.1 to 7.8). PCO directly correlated with change in OKS (p < 0.001). Linear regression analysis confirmed the independent effect of PCO on the OKS (p < 0.001) and the SF-12 physical score (p = 0.02). The overall rate of satisfaction was 85% and on logistic regression analysis improvement in the OKS (p = 0.002) was a significant predictor of patient satisfaction, which is related to PCO; although this was not independently associated with satisfaction. CONCLUSION: Preservation of PCO should be a major consideration when undertaking revision TKA. The option of increasing PCO to balance the flexion gap while maintaining the joint line should be assessed intra-operatively.Cite this article: N. D. Clement, D. J. MacDonald, D. F. Hamilton, R. Burnett. Posterior condylar offset is an independent predictor of functional outcome after revision total knee arthroplasty. Bone Joint Res 2017;6:172-178. DOI: 10.1302/2046-3758.63.BJR-2015-0021.R1.
OBJECTIVES: Preservation of posterior condylar offset (PCO) has been shown to correlate with improved functional results after primary total knee arthroplasty (TKA). Whether this is also the case for revision TKA, remains unknown. The aim of this study was to assess the independent effect of PCO on early functional outcome after revision TKA. METHODS: A total of 107 consecutive aseptic revision TKAs were performed by a single surgeon during an eight-year period. The mean age was 69.4 years (39 to 85) and there were 59 female patients and 48 male patients. The Oxford Knee Score (OKS) and Short-form (SF)-12 score were assessed pre-operatively and one year post-operatively. Patient satisfaction was also assessed at one year. Joint line and PCO were assessed radiographically at one year. RESULTS: There was a significant improvement in the OKS (10.6 points, 95% confidence interval (CI) 8.8 to 12.3) and the SF-12 physical component score (5.9, 95% CI 4.1 to 7.8). PCO directly correlated with change in OKS (p < 0.001). Linear regression analysis confirmed the independent effect of PCO on the OKS (p < 0.001) and the SF-12 physical score (p = 0.02). The overall rate of satisfaction was 85% and on logistic regression analysis improvement in the OKS (p = 0.002) was a significant predictor of patient satisfaction, which is related to PCO; although this was not independently associated with satisfaction. CONCLUSION: Preservation of PCO should be a major consideration when undertaking revision TKA. The option of increasing PCO to balance the flexion gap while maintaining the joint line should be assessed intra-operatively.Cite this article: N. D. Clement, D. J. MacDonald, D. F. Hamilton, R. Burnett. Posterior condylar offset is an independent predictor of functional outcome after revision total knee arthroplasty. Bone Joint Res 2017;6:172-178. DOI: 10.1302/2046-3758.63.BJR-2015-0021.R1.
Authors: Arun Kannan; Robert S O'Connell; Niraj Kalore; Brian M Curtin; Jason R Hull; William A Jiranek Journal: J Arthroplasty Date: 2014-12-13 Impact factor: 4.757
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