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PREOPERATIVE KNEE FUNCTION PREDICTS THE SEQUENTIAL IMPROVEMENT IN CLINICAL & FUNCTIONAL OUTCOMES FOLLOWING TOTAL KNEE ARTHROPLASTY



Abstract

Introduction: Predicting outcomes in the heterogenous population undergoing Total Knee Arthroplasty (TKA) is difficult. This prospective multi-centre study details the relationship between preoperative knee function and the sequential clinical and functional outcome progression of TKA.

Methods: Annual clinical and functional outcome scores (Oxford Knee Score & Knee Society Score) from 526 primary cemented Kinemax TKA implanted into 506 patients over a period of 3 years were assessed. Depending on preoperative knee function, patients were grouped into 3 cohorts: mild, moderate and severe.

Results: At one year there was a significantly (p< 0.05) greater improvement in Oxford Knee Score, Knee Society Score and range of movement in patients with severe preoperative knee function in comparison to the mild cohort. However, a significantly greater improvement (p< 0.05) in functional outcome was shown in patients with mild preoperative knee function.

Only patients with severe preoperative knee function showed deterioration in outcome measures from three years, all other patients maintained improvements.

Discussion: Severe, in comparison to mild, preoperative knee function predicts greater clinical but inferior functional improvement at one year, with deterioration in all outcome measures commencing from three years. Mild to moderate preoperative knee function affords ongoing sequential improvement in clinical and functional outcomes.

Correspondence should be addressed to Mr Tim Wilton, BASK at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.