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Pain and function in patients after primary unicompartmental and total knee arthroplasty.
J Bone Joint Surg Am. 2010 Dec 15; 92(18):2890-7.JB

Abstract

BACKGROUND

Unicompartmental knee arthroplasty has received renewed interest; however, its short-term advantages over total knee arthroplasty should be weighed against a higher risk of reoperation. Information regarding pain and function after unicompartmental and total knee arthroplasty is therefore needed.

METHODS

Patient-reported data regarding pain and function were collected, at least two years postoperatively and by way of postal questionnaire, from 1344 patients who were listed on the Norwegian Arthroplasty Register as having had an unrevised primary total knee arthroplasty (972 patients) or a unicompartmental knee arthroplasty (372 patients) for the treatment of arthritis. Outcomes were assessed (with a score of zero indicating the worst possible outcome and a score of 100 indicating the best possible outcome) with use of the five subscales from the Knee Injury and Osteoarthritis Outcome Score, the scores from visual analog scales regarding degree of pain and satisfaction with the surgery, and the change in index score (from preoperative to postoperative) on the EuroQol-5D health-related quality-of-life instrument. We also used all forty-two questions from the Knee Injury and Osteoarthritis Outcome Score as outcome measures. To be regarded as clinically significant, the differences needed to be eight units for the Knee Injury and Osteoarthritis Outcome Score outcomes, ten units for the pain and satisfaction scales, and 0.4 unit for the detailed Knee Injury and Osteoarthritis Outcome Score questions.

RESULTS

Unicompartmental knee implants performed better than total knee implants on the Knee Injury and Osteoarthritis Outcome subscales for "Symptoms" (adjusted mean difference, 2.7; p = 0.04), "Function in Daily Living" (adjusted mean difference, 4.1; p = 0.01), and "Function in Sport and Recreation" (adjusted mean difference, 5.4; p = 0.006). Of the forty-two analyses of the detailed questions, four differences were significant. These differences were in favor of unicompartmental knee arthroplasty, but only the question "Can you bend your knee fully?" reached the level of clinical significance.

CONCLUSIONS

We found only small or no differences in pain and function between the scores, at least two years following surgery, of patients who underwent unicompartmental knee arthroplasty and those of patients who underwent total knee arthroplasty; however, patients with unicompartmental knee implants had fewer problems with activities that involved bending the knee.

Authors+Show Affiliations

The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Møllendalsbakken 11, N-5021 Bergen, Norway. stein.lygre@helse-bergen.noNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21159989

Citation

Lygre, Stein Håkon Låstad, et al. "Pain and Function in Patients After Primary Unicompartmental and Total Knee Arthroplasty." The Journal of Bone and Joint Surgery. American Volume, vol. 92, no. 18, 2010, pp. 2890-7.
Lygre SH, Espehaug B, Havelin LI, et al. Pain and function in patients after primary unicompartmental and total knee arthroplasty. J Bone Joint Surg Am. 2010;92(18):2890-7.
Lygre, S. H., Espehaug, B., Havelin, L. I., Furnes, O., & Vollset, S. E. (2010). Pain and function in patients after primary unicompartmental and total knee arthroplasty. The Journal of Bone and Joint Surgery. American Volume, 92(18), 2890-7. https://doi.org/10.2106/JBJS.I.00917
Lygre SH, et al. Pain and Function in Patients After Primary Unicompartmental and Total Knee Arthroplasty. J Bone Joint Surg Am. 2010 Dec 15;92(18):2890-7. PubMed PMID: 21159989.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pain and function in patients after primary unicompartmental and total knee arthroplasty. AU - Lygre,Stein Håkon Låstad, AU - Espehaug,Birgitte, AU - Havelin,Leif Ivar, AU - Furnes,Ove, AU - Vollset,Stein Emil, PY - 2010/12/17/entrez PY - 2010/12/17/pubmed PY - 2011/1/25/medline SP - 2890 EP - 7 JF - The Journal of bone and joint surgery. American volume JO - J Bone Joint Surg Am VL - 92 IS - 18 N2 - BACKGROUND: Unicompartmental knee arthroplasty has received renewed interest; however, its short-term advantages over total knee arthroplasty should be weighed against a higher risk of reoperation. Information regarding pain and function after unicompartmental and total knee arthroplasty is therefore needed. METHODS: Patient-reported data regarding pain and function were collected, at least two years postoperatively and by way of postal questionnaire, from 1344 patients who were listed on the Norwegian Arthroplasty Register as having had an unrevised primary total knee arthroplasty (972 patients) or a unicompartmental knee arthroplasty (372 patients) for the treatment of arthritis. Outcomes were assessed (with a score of zero indicating the worst possible outcome and a score of 100 indicating the best possible outcome) with use of the five subscales from the Knee Injury and Osteoarthritis Outcome Score, the scores from visual analog scales regarding degree of pain and satisfaction with the surgery, and the change in index score (from preoperative to postoperative) on the EuroQol-5D health-related quality-of-life instrument. We also used all forty-two questions from the Knee Injury and Osteoarthritis Outcome Score as outcome measures. To be regarded as clinically significant, the differences needed to be eight units for the Knee Injury and Osteoarthritis Outcome Score outcomes, ten units for the pain and satisfaction scales, and 0.4 unit for the detailed Knee Injury and Osteoarthritis Outcome Score questions. RESULTS: Unicompartmental knee implants performed better than total knee implants on the Knee Injury and Osteoarthritis Outcome subscales for "Symptoms" (adjusted mean difference, 2.7; p = 0.04), "Function in Daily Living" (adjusted mean difference, 4.1; p = 0.01), and "Function in Sport and Recreation" (adjusted mean difference, 5.4; p = 0.006). Of the forty-two analyses of the detailed questions, four differences were significant. These differences were in favor of unicompartmental knee arthroplasty, but only the question "Can you bend your knee fully?" reached the level of clinical significance. CONCLUSIONS: We found only small or no differences in pain and function between the scores, at least two years following surgery, of patients who underwent unicompartmental knee arthroplasty and those of patients who underwent total knee arthroplasty; however, patients with unicompartmental knee implants had fewer problems with activities that involved bending the knee. SN - 1535-1386 UR - https://www.unboundmedicine.com/medline/citation/21159989/Pain_and_function_in_patients_after_primary_unicompartmental_and_total_knee_arthroplasty_ L2 - http://dx.doi.org/10.2106/JBJS.I.00917 DB - PRIME DP - Unbound Medicine ER -