TY - JOUR
T1 - Who Will Benefit From Kinematically Aligned Total Knee Arthroplasty? Perspectives on Patient-Reported Outcome Measures
AU - Niki, Yasuo
AU - Nagura, Takeo
AU - Kobayashi, Shu
AU - Udagawa, Kazuhiko
AU - Harato, Kengo
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/2
Y1 - 2020/2
N2 - Background: Indications for kinematically aligned total knee arthroplasty (KA-TKA) have remained contentious. This study aimed at exploring preoperative characteristics of patients who were suitable for and benefited from KA-TKA, based on the assessment of patient-reported outcome measures (PROMs). Methods: Subjects comprised 100 patients undergoing KA-TKA and 100 patients undergoing mechanically aligned (MA)-TKA due to end-stage osteoarthritis. Bone cuts were performed using portable navigation systems according to 3D planning data from computed tomography. At 2 years postoperatively, all 200 patients were assessed for PROMs, including Knee Society Score 2011, pain catastrophizing scale, and pain DETECT score. Multiple regression analysis was performed with activity subscore set as a dependent variable. Principal component analysis was used to evaluate patient satisfaction and function components transformed from the 3 PROMs and to compare these components between KA-TKA and MA-TKA. Results: Male gender or use of KA technique positively affected advanced activity score, whereas age, body mass index, preoperative pain DETECT score, and preoperative femorotibial angle showed negative effects. In principal component analysis, 38 KA-TKA patients achieved a higher function score, with satisfaction scores comparable to those from MA-TKA. These 38 patients were characterized by a higher percentage of males, younger age, and higher preoperative total activity score. Conclusion: From the perspective of PROMs, KA-TKA should be favored over MA-TKA for young active males, because these patient groups achieved higher functional activity when undergoing KA-TKA.
AB - Background: Indications for kinematically aligned total knee arthroplasty (KA-TKA) have remained contentious. This study aimed at exploring preoperative characteristics of patients who were suitable for and benefited from KA-TKA, based on the assessment of patient-reported outcome measures (PROMs). Methods: Subjects comprised 100 patients undergoing KA-TKA and 100 patients undergoing mechanically aligned (MA)-TKA due to end-stage osteoarthritis. Bone cuts were performed using portable navigation systems according to 3D planning data from computed tomography. At 2 years postoperatively, all 200 patients were assessed for PROMs, including Knee Society Score 2011, pain catastrophizing scale, and pain DETECT score. Multiple regression analysis was performed with activity subscore set as a dependent variable. Principal component analysis was used to evaluate patient satisfaction and function components transformed from the 3 PROMs and to compare these components between KA-TKA and MA-TKA. Results: Male gender or use of KA technique positively affected advanced activity score, whereas age, body mass index, preoperative pain DETECT score, and preoperative femorotibial angle showed negative effects. In principal component analysis, 38 KA-TKA patients achieved a higher function score, with satisfaction scores comparable to those from MA-TKA. These 38 patients were characterized by a higher percentage of males, younger age, and higher preoperative total activity score. Conclusion: From the perspective of PROMs, KA-TKA should be favored over MA-TKA for young active males, because these patient groups achieved higher functional activity when undergoing KA-TKA.
KW - functional activity
KW - kinematically aligned total knee arthroplasty
KW - patient satisfaction
KW - patient-reported outcome measure
KW - surgical indication
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U2 - 10.1016/j.arth.2019.09.035
DO - 10.1016/j.arth.2019.09.035
M3 - Article
C2 - 31668528
AN - SCOPUS:85074408163
SN - 0883-5403
VL - 35
SP - 438-442.e2
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 2
ER -