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Postoperative fixed flexion deformity greater than 10° lead to poorer functional outcome 10 years after unicompartmental knee arthroplasty.
Knee Surg Sports Traumatol Arthrosc. 2018 Jun; 26(6):1723-1727.KS

Abstract

PURPOSE

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.

METHODS

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).

RESULTS

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.

CONCLUSIONS

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.

LEVEL OF EVIDENCE

Prognostic level II.

Authors+Show Affiliations

Duke-NUS Medical School, Singapore, Singapore. jared.yeh.zy@gmail.com.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28993855

Citation

Yeh, Jared Ze Yang, et al. "Postoperative Fixed Flexion Deformity Greater Than 10° Lead to Poorer Functional Outcome 10 Years After Unicompartmental Knee Arthroplasty." Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, vol. 26, no. 6, 2018, pp. 1723-1727.
Yeh JZY, Chen JY, Lim JW, et al. Postoperative fixed flexion deformity greater than 10° lead to poorer functional outcome 10 years after unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2018;26(6):1723-1727.
Yeh, J. Z. Y., Chen, J. Y., Lim, J. W., Pang, H. N., Tay, D. K. J., Chia, S. L., Lo, N. N., & Yeo, S. J. (2018). Postoperative fixed flexion deformity greater than 10° lead to poorer functional outcome 10 years after unicompartmental knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, 26(6), 1723-1727. https://doi.org/10.1007/s00167-017-4749-6
Yeh JZY, et al. Postoperative Fixed Flexion Deformity Greater Than 10° Lead to Poorer Functional Outcome 10 Years After Unicompartmental Knee Arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2018;26(6):1723-1727. PubMed PMID: 28993855.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postoperative fixed flexion deformity greater than 10° lead to poorer functional outcome 10 years after unicompartmental knee arthroplasty. AU - Yeh,Jared Ze Yang, AU - Chen,Jerry Yongqiang, AU - Lim,Joel Wei-An, AU - Pang,Hee Nee, AU - Tay,Darren Keng Jin, AU - Chia,Shi-Lu, AU - Lo,Ngai Nung, AU - Yeo,Seng Jin, Y1 - 2017/10/09/ PY - 2017/07/23/received PY - 2017/10/04/accepted PY - 2017/10/11/pubmed PY - 2018/9/27/medline PY - 2017/10/11/entrez SP - 1723 EP - 1727 JF - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA JO - Knee Surg Sports Traumatol Arthrosc VL - 26 IS - 6 N2 - PURPOSE: 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. METHODS: 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). RESULTS: 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. CONCLUSIONS: 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. LEVEL OF EVIDENCE: Prognostic level II. SN - 1433-7347 UR - https://www.unboundmedicine.com/medline/citation/28993855/Postoperative_fixed_flexion_deformity_greater_than_10°_lead_to_poorer_functional_outcome_10_years_after_unicompartmental_knee_arthroplasty_ L2 - https://dx.doi.org/10.1007/s00167-017-4749-6 DB - PRIME DP - Unbound Medicine ER -