Who Will Benefit From Kinematically Aligned Total Knee Arthroplasty? Perspectives on Patient-Reported Outcome Measures

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Abstract

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.

Original languageEnglish
JournalJournal of Arthroplasty
DOIs
Publication statusAccepted/In press - 2019 Jan 1

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Knee Replacement Arthroplasties
Principal Component Analysis
Catastrophization
Pain
Patient Reported Outcome Measures
Patient Satisfaction
Osteoarthritis
Body Mass Index
Tomography
Regression Analysis
Bone and Bones

Keywords

  • functional activity
  • kinematically aligned total knee arthroplasty
  • patient satisfaction
  • patient-reported outcome measure
  • surgical indication

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

@article{d30af84cbd40416787866d67347cd9a2,
title = "Who Will Benefit From Kinematically Aligned Total Knee Arthroplasty? Perspectives on Patient-Reported Outcome Measures",
abstract = "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.",
keywords = "functional activity, kinematically aligned total knee arthroplasty, patient satisfaction, patient-reported outcome measure, surgical indication",
author = "Yasuo Niki and Takeo Nagura and Shu Kobayashi and Kazuhiko Udagawa and Kengo Harato",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.arth.2019.09.035",
language = "English",
journal = "Journal of Arthroplasty",
issn = "0883-5403",
publisher = "Churchill Livingstone",

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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

PY - 2019/1/1

Y1 - 2019/1/1

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.

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