Clinical Outcomes of a Modern Total Knee Arthroplasty Prosthesis Compared to Its Predecessor at 5-Year Follow-Up: Matched Pair Analysis |
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| Institution: | 1. Barbara Zucker School of Medicine at Hofstra/Northwell at Plainview Hospital, Plainview, New York;2. University of Queensland, Ochsner, Brisbane, Queensland, Australia;3. Virginia Commonwealth University, Richmond, VA;4. Hospital for Special Surgery, New York, NY;1. The Orthopaedic Speciality Clinic, 16 Status Chambers, 1221/A Wrangler Paranjpe Road, Off F.C. Road, Pune, 411004, India;2. Department of Translational Medicine & Research, SRM Medical College and Hospitals, SRM Institute of Science & Technology, Kattankulathur, Tamil Nadu, 603203, India;1. Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, Bristol, United Kingdom;2. National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, United Kingdom;3. Department of Oncology and Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Sheffield, United Kingdom;4. Metabolic Bone Unit, Sorby Wing, Northern General Hospital, Sheffield, United Kingdom;1. Centre for Musculoskeletal Outcomes Research, Department of Surgical Sciences, University of Otago, Dunedin, New Zealand;2. Department of Surgery, St Vincent’s Hospital, University of Melbourne, Melbourne, Victoria, Australia;1. Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA;2. Department of Political Science, Temple University, Philadelphia, PA;3. Drexel University College of Medicine, Philadelphia, PA;1. University of Tennessee Health Science Center, College of Medicine, Memphis, TN;2. Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, Cleveland, OH;3. Department of Hospital Medicine, Cleveland Clinic Foundation, Cleveland, OH;4. Center for Value-Based Care Research, Cleveland Clinic Foundation, Cleveland, OH |
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| Abstract: | BackgroundResidual pain is an important cause of patient dissatisfaction after total knee arthroplasty (TKA). A recent study at our institution found that a modern prosthesis was associated with less residual and anterior knee pain at 2-year follow-up when compared to its predecessor. The aim of this study is to evaluate these implants at 5-year follow-up.MethodsFrom July 2012 to December 2013, 100 consecutive modern TKAs were identified from our prospective Institutional Review Board approved database. All patients with 5-year clinical follow-up (n = 77) were matched in a one-to-one fashion based on age, gender, body mass index, and follow-up with a predecessor TKA. Clinical outcomes were assessed with a patient-administered questionnaire for specifically anterior knee pain, painless noise, painful crepitation, and satisfaction. Overall function was assessed using Knee Society Scores and Western Ontario and McMaster University Osteoarthritis Index.ResultsAt 5-year follow-up, there were no significant differences between the modern TKA and a predecessor TKA in the Knee Society pain or function scores (P = .24 and P = .54, respectively). The overall prevalence of residual pain was less with the modern TKA compared to its predecessor (19.5% vs 36.3%; P = .02), but the prevalence of isolated anterior knee pain was similar in both cohorts (11.7% vs 22.1%; P = .09). There was no difference in painless noise (19.5% vs 13.3%; P = .28) or satisfaction scores (7.9 ± 2.4 vs 7.6 ± 2.6; P = .25) between the modern and predecessor cohorts.ConclusionAt 5-year follow-up, we found that both the modern and predecessor prostheses provided excellent clinical outcomes. The modern TKA was associated with less residual pain compared to its predecessor, but we were unable to detect differences in the prevalence of isolated anterior knee pain, painless noise, Knee Society Scores, or radiographic evaluation. |
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| Keywords: | anterior knee pain residual pain total knee patient satisfaction modern TKA |
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