Clin Orthop Surg.  2018 Sep;10(3):337-343. 10.4055/cios.2018.10.3.337.

Acceptable Functional Outcomes and Patient Satisfaction Following Total Knee Arthroplasty in Asians with Severe Knee Stiffness: A Matched Analysis

Affiliations
  • 1Duke University, Durham, NC, USA.
  • 2SingHealth Duke-NUS Musculoskeletal Sciences Academic Clinical Program, Singapore. hamidrazak@gmail.com

Abstract

BACKGROUND
This study evaluated outcomes following total knee arthroplasty for severely stiff knees in Asians.
METHODS
Registry data of patients undergoing primary total knee arthroplasty between 2004 and 2013 were collected and retrospectively reviewed. Sociodemographic and anthropometric data together with the Oxford Knee Score and the Knee Society Score (Knee Society Knee Score and the Knee Society Function Score) were collected both preoperatively and postoperatively for up to 2 years. Case subjects consisted of patients with a preoperative flexion range of ≤ 20°. Control subjects consisted of patients with a preoperative flexion range of > 90°. Patients were matched for age, sex, and all preoperative scores in a 2:1 fashion. Two-year outcomes and 5-year revision rates were then compared between cases and controls.
RESULTS
There were 28 cases and 56 controls. Cases had a significantly lower body mass index than the controls (p = 0.003) and had a longer hospital stay (p < 0.0001). At 2 years, cases had a significantly lower flexion range (p < 0.001) and a lower Knee Society Function Score (p = 0.020) than the controls. Cases had a significantly greater improvement in the flexion range (p < 0.001) postoperatively than controls. The mean change in functional outcomes at 2 years was comparable between the two groups. Seventy-one percent of the cases and 88% of controls were satisfied. There was a significant difference in the 5-year revision rate (10% vs 0%, p = 0.013). More cases were discharged to a rehabilitation facility compared to controls (p = 0.011). There were no differences in inpatient complication rates.
CONCLUSIONS
Functional outcomes and patient satisfaction were acceptable following total knee arthroplasty in Asian patients with severe knee stiffness.

Keyword

Ankylosis; Arthroplasty; Asian Continental Ancestral Group; Minimal clinically important difference

MeSH Terms

Ankylosis
Arthroplasty
Arthroplasty, Replacement, Knee*
Asian Continental Ancestry Group*
Body Mass Index
Humans
Inpatients
Knee*
Length of Stay
Patient Satisfaction*
Rehabilitation
Retrospective Studies

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