Christiaan Rudolf Oosthuizen1,2, Catherine Van Der Straeten3, Innocent Maposa4, Christian Hugo Snyckers5, Duwayne Peter Vermaak5, Sebastian Magobotha6. 1. Private Orthopaedic Practice, Johannesburg, South Africa. drcroosthuizen@gmail.com. 2. Division of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg, South Africa. drcroosthuizen@gmail.com. 3. Head of the Health Innovation and Research Institute, Ghent University Hospital, Ghent, Belgium. 4. Faculty of Health Sciences, Wits School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. 5. Private Orthopaedic Practice, Pretoria, South Africa. 6. Division of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg, South Africa.
Abstract
INTRODUCTION: The validated Knee Osteoarthritis Grading System (KOGS) was implemented and clinical results were compared with patient satisfaction data and implant survivorship in a multi-centre study with surgeons familiar with unicompartmental knee arthroplasty (UKA), patellofemoral arthroplasty (PFA) and total knee arthroplasty (TKA). This is also the first study to evaluate the prevalence of UKA and TKA in consecutive osteoarthritis (OA) knee arthroplasties assessed by this system.. METHOD: A consecutive cohort of knees was gathered at three different institutions as categorized by KOGS and surgically treated with the recommended implant unless clinical reasons or patient preference precluded such an option. One thousand one hundred seventy-seven consecutive knees were evaluated including 311 TKA (26%), 695 medial UKA (59%), 154 lateral UKA (13%) and 17 PFA (2%) and the results of the categories evaluated with the Oxford Knee Score (OKS) and the complications reflected in the different categories. RESULTS: The failure rate of the UKA (3.5%) or TKA (1.6%) is not higher than accepted results in the literature and the difference in complications is negligible between the UKA (72%) and TKA (26%) cohorts. Revision of a UKA to a TKA as an endpoint was 0.58% with ipsilateral progression at 0.8% over a period of five to 84 months (mean follow-up of 36 months) despite the 'excessive' proportion of UKA in this cohort. The Oxford Score improvement is significant in TKA and UKA and contributes to the acceptable outcomes (The OKS for TKA improved from 20 pre-operatively to 36 post-operatively and the UKA improved from 22 pre-operatively to 39 post-operatively). CONCLUSION: KOGS achieves acceptable early survival and functional results when implemented and is a suitable tool for identifying the preferred implant as was validated.
INTRODUCTION: The validated Knee Osteoarthritis Grading System (KOGS) was implemented and clinical results were compared with patient satisfaction data and implant survivorship in a multi-centre study with surgeons familiar with unicompartmental knee arthroplasty (UKA), patellofemoral arthroplasty (PFA) and total knee arthroplasty (TKA). This is also the first study to evaluate the prevalence of UKA and TKA in consecutive osteoarthritis (OA) knee arthroplasties assessed by this system.. METHOD: A consecutive cohort of knees was gathered at three different institutions as categorized by KOGS and surgically treated with the recommended implant unless clinical reasons or patient preference precluded such an option. One thousand one hundred seventy-seven consecutive knees were evaluated including 311 TKA (26%), 695 medial UKA (59%), 154 lateral UKA (13%) and 17 PFA (2%) and the results of the categories evaluated with the Oxford Knee Score (OKS) and the complications reflected in the different categories. RESULTS: The failure rate of the UKA (3.5%) or TKA (1.6%) is not higher than accepted results in the literature and the difference in complications is negligible between the UKA (72%) and TKA (26%) cohorts. Revision of a UKA to a TKA as an endpoint was 0.58% with ipsilateral progression at 0.8% over a period of five to 84 months (mean follow-up of 36 months) despite the 'excessive' proportion of UKA in this cohort. The Oxford Score improvement is significant in TKA and UKA and contributes to the acceptable outcomes (The OKS for TKA improved from 20 pre-operatively to 36 post-operatively and the UKA improved from 22 pre-operatively to 39 post-operatively). CONCLUSION:KOGS achieves acceptable early survival and functional results when implemented and is a suitable tool for identifying the preferred implant as was validated.
Authors: Antonio Escobar; José Maria Quintana; Immaculada Aróstegui; Jesús Azkárate; José Ignacio Güenaga; Juan Carlos Arenaza; Idoia Garai Journal: Int J Technol Assess Health Care Date: 2003 Impact factor: 2.188
Authors: Michele d'Amato; Andrea Ensini; Alberto Leardini; Paolo Barbadoro; Andrea Illuminati; Claudio Belvedere Journal: Int Orthop Date: 2018-09-08 Impact factor: 3.075
Authors: Hannah A Wilson; Rob Middleton; Simon G F Abram; Stephanie Smith; Abtin Alvand; William F Jackson; Nicholas Bottomley; Sally Hopewell; Andrew J Price Journal: BMJ Date: 2019-02-21