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- Title
Postoperative fixed flexion deformity greater than 10° lead to poorer functional outcome 10 years after unicompartmental knee arthroplasty.
- Authors
Yeh, Jared Ze Yang; Chen, Jerry Yongqiang; Lim, Joel Wei-An; Pang, Hee Nee; Tay, Darren Keng Jin; Chia, Shi-Lu; Lo, Ngai Nung; Yeo, Seng Jin
- Abstract
<bold>Purpose: </bold>The primary aim of this study was to evaluate the influence of postoperative fixed flexion deformity (FFD) on the clinical outcomes 10 years after unicompartmental knee arthroplasty (UKA). The secondary aim was to identify predictors for the occurrence of postoperative FFD.<bold>Methods: </bold>Patients who underwent UKA between 2003 and 2007 were prospectively followed up for 10 years. A total of 172 patients were categorized into 3 groups based on the amount of postoperative FFD: (1) 0° or less (Min-FFD), (2) 1°-9° (Mid-FFD), and (3) 10° or more (Max-FFD). Functional outcome was quantified using Knee Society Function Score (KSFS), Knee Society Knee Score (KSKS) and Oxford Knee Score (OKS).<bold>Results: </bold>At 10 years after UKA, the mean KSKS and OKS were 6 ± 5 (95% CI 6-18, p = 0.050) and 5 ± 2 (95% CI 0-9, p = 0.041) points lower in patients with Max-FFD than those with Min-FFD. Other clinical outcomes were not different between groups. Patients with a higher preoperative body mass index (OR 1.122 per unit increase, 95% CI 1.006-1.253, p = 0.040) or worse preoperative FFD (OR 1.108 per unit increase, 95% CI 1.022-1.201, p = 0.013) were at increased risk of having postoperative FFD of 10° or more at 10 years after UKA.<bold>Conclusions: </bold>The clinical relevance of this study was to demonstrate the long-term negative correlation between severe postoperative FFD and functional outcome and, therefore, the importance of achieving good knee alignment after UKA. The authors recommend that FFD should be fully corrected intra-operatively if possible while preserving knee balance and stable dynamic function through full range of motion.<bold>Level Of Evidence: </bold>Prognostic level II.
- Subjects
TOTAL knee replacement; KNEE surgery; SURGICAL complications; BODY mass index; JOINT infections; JOINT disease diagnosis; OSTEOARTHRITIS diagnosis; ARTIFICIAL joints; JOINT diseases; RANGE of motion of joints; KNEE diseases; OSTEOARTHRITIS; RECOVERY rooms; DIAGNOSIS
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2018, Vol 26, Issue 6, p1723
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-017-4749-6