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ABSTRACT: The objective of this retrospective review of 466 patients was to document changes in limb length, leg length discrepancy (LLD), height, weight, and body mass index (BMI) 1year after TKA and the patterns of height, weight, and BMI during 5years. To determine change patterns over 5years, the data of 291 patients were analyzed and compared with those of age and gender-matched normal subjects. Limb length, height, and weight increased, BMI remained unchanged, and LLD decreased 1year after TKA. The bilateral group had a greater height increase and lower rate of LLD. Preoperative mechanical tibiofemoral angle was related to limb length increase, and patients with a smaller preoperative BMI showed more weight gain. During the 5years, weight and BMI at 1year were maintained, but height diminished, while the healthy population showed a decreasing trend in weight.
The Journal of arthroplasty 04/2013; · 1.79 Impact Factor
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ABSTRACT: PURPOSE: Despite the documented blood-saving effects of tranexamic acid (TNA) in total knee arthroplasty (TKA), the question whether clinical values of TNA are identical in unilateral and bilateral TKAs remains unclear. This study was undertaken to determine the clinical values of TNA in unilateral and simultaneous bilateral TKAs under a contemporary blood-saving protocol in terms of efficacy (total blood loss and transfusion rate) and safety (the incidences of symptomatic deep vein thrombosis and pulmonary embolism). METHODS: One hundred and eighty unilateral and 146 bilateral TKA patients were randomized into TNA group or control group. In unilateral TKA patients, TNA (10 mg/kg) was administered intravenously 20 min before tourniquet deflation and repeated 3 h after surgery. In bilateral TKA patients, one more dose (10 mg/kg) was given before tourniquet deflation in the second TKA. A contemporary blood-saving protocol was applied to all patients. The TNA and control groups were compared separately in unilateral and bilateral TKA patients for the efficacy and safety variables. RESULTS: In unilateral TKA patients, the TNA group had less total blood loss (905 vs. 1,018 mL, p = 0.018) than the control group, but there was no difference in the allogenic transfusion rate (1 vs. 7 %, n.s.). In bilateral TKA patients, the TNA group showed no differences in total blood loss (1,282 vs. 1,379 mL, n.s.), but a significant reduction in the allogenic transfusion rate (7 vs. 27 %, p = 0.002). No symptomatic deep vein thrombosis or pulmonary embolism was found in all patients. CONCLUSION: This study demonstrates that the use of TNA reduces total blood loss, but the effects on the transfusion rate can differ depending on the type of TKAs (unilateral vs. bilateral) and the blood-saving protocols. LEVEL OF EVIDENCE: Therapeutic study, Level I (double blind randomized controlled trial).
Knee Surgery Sports Traumatology Arthroscopy 04/2013; · 2.21 Impact Factor
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ABSTRACT: BACKGROUND: In studies of TKA, treating each knee as an independent case in patients with bilateral TKAs can lead to errors, because patients with bilateral and unilateral TKAs may achieve different levels of function and because the assumption of statistical independence is violated. QUESTIONS/PURPOSES: We determined whether (1) patients undergoing bilateral TKAs have different demographics and preoperative and postoperative function from those undergoing unilateral TKAs, and (2) means, SEs, and p values change substantially based on how the two cases of bilateral TKAs are treated in statistical analyses. METHODS: We retrospectively compared 513 patients undergoing unilateral TKAs and 602 patients undergoing bilateral TKAs regarding demographics (age, gender, BMI), preoperative and 1-year postoperative function (motion arc, American Knee Society score, patellofemoral score, WOMAC(TM), SF-36). Each case of a bilateral TKA was treated as independent in the reference analyses. Then changes of mean, SEs, and p values were compared with those of the reference method when three other methods of analysis were used: using mean values of both knees, randomly selecting one side, and using a generalized estimating equation. RESULTS: Patients undergoing bilateral TKAs had higher female predominance (95% versus 90%) and BMI (27.4 versus 26.1 kg/m(2)) than those undergoing unilateral TKAs. Although patients undergoing bilateral TKAs had worse preoperative function, they achieved comparable function at 1 year. The mean values did not differ considerably depending on the four methods. The SEs and p values of the reference method were generally the smallest, but the differences appeared negligible. CONCLUSIONS: Our analyses suggest bilaterality can be ignored in the analysis of TKA, since postoperative function is comparable between unilateral and bilateral TKAs and the theoretical errors in statistical analysis had little effect on the results.
Clinical Orthopaedics and Related Research 01/2013; · 2.53 Impact Factor
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The Journal of arthroplasty 12/2012; · 1.79 Impact Factor
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ABSTRACT: Patients who present with large flexion contracture (FC) but have well maintained maximum flexion tend to have a flexion-extension gap mismatch, which can cause residual FC or flexion instability after TKA. We routinely use posterior-stabilized implants, perform soft tissue balancing and additional distal femur resection, and determine the polyethylene insert thickness based on flexion-extension gap difference to avoid postoperative FC and flexion instability. We retrospectively reviewed 911 TKAs performed with this protocol to determine the incidence, predictors and effects of postoperative FC on clinical outcomes. Knees with postoperative FC ≥10° were identified, and their clinical outcomes were compared with knees without FC. The average follow-up period was 35months (range, 24-72months). Eighteen (2.0%) of the 911 knees presented with postoperative FC. The occurrence of postoperative FC was associated with preoperative FC and anterior knee pain, but not with a flexion-extension gap mismatch. A mild to moderate postoperative FC does not increase pain, but may be detrimental to quality of life.
The Journal of arthroplasty 11/2012; · 1.79 Impact Factor
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ABSTRACT: This study was performed to establish simple algorithms to predict proper screw lengths for the 4 proximal holes of TomoFix plates (Synthes GmbH; Solothurn, Switzerland) based on radiographic mediolateral (ML) and anteroposterior (AP) dimensions of the proximal tibia and to determine how well these algorithms function for navigation-controlled medial opening-wedge high tibial osteotomy (HTO) using TomoFix. Experimental HTO surgery was performed in proximal tibial models manufactured for 30 patients undergoing HTO to determine the longest screw lengths for the 4 proximal holes of TomoFix plates. Eight algorithms were created for the 4 proximal screws by investigating the relationships between measured screw lengths and radiographic dimensions and were used for 30 navigation-controlled medial opening-wedge HTOs. The algorithms used to predict screw length were: screw A=ML width-20 mm and AP length+5 mm; screw B=ML width-25 mm and AP length; screw C=ML width-35 mm and AP length-10 mm; and screw D=ML width-40 mm and AP length-15 mm. All 30 surgeries were performed with no perioperative adverse events. Mean operative time was 47.1 minutes, and no far cortex perforation of more than 3 mm was observed for any of the 4 proximal screws. Mean mechanical tibiofemoral angle and weight load line coordinate at the knee joint were valgus 3.7° and 62.9%, respectively. Targeted alignment was achieved in 28 (93%) knees for a mechanical tibiofemoral angle between valgus 2° and 6°, and in 25 (83%) knees for a weight load line coordinate between 55% and 70%. The authors propose the use of the developed algorithms to select proper screw lengths for medial opening wedge HTO using the TomoFix HTO system.
Orthopedics 10/2012; 35(10):22-8. · 2.66 Impact Factor
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ABSTRACT: BACKGROUND: Coronal alignment is considered key to the function and longevity of a TKA. However, most studies do not consider femoral and tibial anatomical features such as lateral femoral bowing and the effects of these features and subsequent alignment on function after TKA are unclear. QUESTIONS/PURPOSES: We therefore determined (1) the prevalence of lateral femoral bowing, varus femoral condylar orientation, and severe tibia plateau inclination in female Koreans undergoing TKA; (2) whether postoperative alignments are affected by these anatomical features and improved by the use of navigation; and (3) whether postoperative coronal alignments are associated with function. METHODS: We measured alignment in 367 knees that underwent TKA and 60 sex- and age-matched normal knees (control group). We determined patterns and degrees of femoral bowing angle, femoral condylar orientation, and tibial plateau inclination on preoperative full-limb radiographs. Postoperatively, coronal alignment of limbs and of femoral and tibial components was measured. We compared American Knee Society scores, WOMAC scores, and SF-36 scores in aligned knees and outliers (beyond ± 3° or ± 2°) at 1 year. RESULTS: The prevalence of lateral femoral bowing was 88% in the TKA group and 77% in the control group. Mean femoral condylar orientation angle was varus 2.6° in the TKA group and valgus 1.1° in the control group, and mean tibial plateau inclination was varus 8.3° in the TKA group and varus 5.4° in the control group. Femoral lateral bowing and varus femoral condylar orientation were associated with postoperative alignments. Several clinical outcome scales were inferior in the outliers in mechanical tibiofemoral angle, anatomical tibiofemoral angle, and tibial coronal alignment but not in femoral coronal alignment outliers. CONCLUSIONS: Lateral femoral bowing, varus condylar orientation, and severe varus inclination of the tibia plateau should be considered when performing TKA in Korean patients or patients with otherwise similar anatomical features.
Clinical Orthopaedics and Related Research 09/2012; · 2.53 Impact Factor
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ABSTRACT: We investigated the safety and efficacy of the bilateral periarticular multimodal drug injection (PMDI) at a reduced dosage in patients undergoing simultaneous bilateral total knee arthroplasty (SBTKA). In total, 45 patients undergoing SBTKA received 65 mL PMDI in each knee (reduced-dose group). The incidence of drug-related adverse effects and wound complications were evaluated. Pain levels during the night of the operation and postoperative day 1 and opioid consumption during the first 24 hours after surgery were compared with the regular-dose group of 55 patients undergoing SBTKA who received 100 mL of PMDI in 1 knee. No patient experienced a serious drug-related adverse effect or wound complication. Blood levels of ropivacaine were observed to be lower than a toxic level throughout the monitored period in all patients examined. Patients in the reduced-dose group experienced less pain during the night of operation, but a similar pain level at postoperative day 1.
The Journal of arthroplasty 06/2012; 27(9):1731-1736.e1. · 1.79 Impact Factor
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ABSTRACT: This study was conducted to longitudinally compare a new floating platform mobile-bearing (MB) prosthesis with an established
fixed-bearing (FB) system with respect to early clinical outcomes in patients with bilateral TKAs using the MB prosthesis
in one knee and the FB prosthesis in the other. Clinical outcomes (ROM, AKS and WOMAC scores, and side preference), evaluated
at 6, 12 and 24months postoperatively, were compared between knees fitted with the MB prosthesis (e.motion-FP) or the FB
prosthesis (Genesis II) in 66 patients who underwent bilateral TKA. In addition, the same comparisons between the knees fitted
with the MB prosthesis and the knees with the FB prosthesis were made separately in the subgroup of 33 patients implanted
with a cruciate retaining FB (FB-CR) prosthesis and the other subgroup of 33 patients with a posteriorly stabilized FB (FB-PS)
prosthesis in a knee. The floating platform MB prosthesis achieved comparable clinical outcomes to the FB prosthesis. No significant
differences were found between the FB- and MB-implanted sides at any time with respect to the outcome scales, and temporal
patterns were similar. However, comparisons of FB-CR and FB-PS patient groups revealed different temporal patterns. In the
FB-CR group, most outcome scales were improved at 6months, peaked at 12months and then remained at this level at 24months.
In contrast, outcomes in the FB-PS group improved much faster to almost peak at 6months, and then remained at this level.
In the FB-CR group, more patients preferred the knee with fitted with a MB prosthesis at 6months. In contrast, in the FB-PS
group, no side preference for the MB prosthesis was observed, and more patients preferred knees implanted with the FB prosthesis
at 12 and 24months. This study demonstrates that this new mobile-bearing prosthesis, designed as a floating platform, provides
satisfactory clinical performances that are comparable to those achieved using the established fixed-bearing prosthesis in
terms of clinical outcomes.
KeywordsTotal knee arthroplasty-Mobile-bearing knee-Fixed-bearing knee-e.motion-FP-Genesis II
Knee Surgery Sports Traumatology Arthroscopy 04/2012; 18(7):879-888. · 2.21 Impact Factor
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ABSTRACT: Information concerning the abilities of radiographic parameters to predict the symptoms of advanced osteoarthritis (OA) of the knee would be valuable, because plain knee radiographs are used as one of the primary tools for the selection of treatment modalities. We aimed to identify the radiographic predictors of symptom severity in patients with varus knee OA advanced enough to warrant total knee arthroplasty (TKA). In 341 knees with primary varus OA warranting TKA, pertinent radiographic features of the medial and lateral tibiofemoral joint (TFJ), and the patellofemoral joint (PFJ) were assessed separately and scored. In addition, TF alignment was assessed on standing full-limb radiographs. Symptoms and functions were evaluated using WOMAC pain and function scores. In the univariate analyses with generalized estimating equations (GEE), multiple radiographic features (subluxation of the TFJ, overall severity of the medial TFJ, and degree of TF varus alignment) were associated with poorer WOMAC function scores, whereas only the degree of TF varus alignment was associated with poorer WOMAC pain scores. None of radiographic parameters in the PFJ or lateral TFJ (except TFJ subluxation) was associated with WOMAC scores. Multivariate analyses revealed that the degree of TF varus alignment was the strongest predictor of poorer WOMAC pain and function scores. We propose that extent of TF varus malalignment should be considered as the primary indicator of objective disease severity when selecting treatment options for patients with advanced knee OA.
The Knee 12/2011; 18(6):456-60. · 1.74 Impact Factor
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ABSTRACT: Although the analgesic effects of periarticular multimodal drug injection (PMDI) after TKA have been well documented, there is little information about additional pain relieving effects of PMDI incorporated to contemporary multimodal pain control protocols which have been proved to provide excellent analgesia. We performed a parallel-group, randomised, controlled study to determine whether PMDI provides additional clinical benefits on contemporary multimodal analgesic protocols including preemptive analgesics, continuous femoral nerve block, and IV-PCA. Eighty-seven patients were randomized to a PMDI group (n=45) or to a No-PMDI group (n=42). Pain level and opioid consumption were compared as primary outcomes. The incidences of narcotic and ropivacaine related side effects and complications, functional recovery, and satisfaction were also compared. The PMDI group experienced less pain during the operation night and the 1st postoperative day and showed lower opioid consumption over 24h after surgery. However, the PMDI group had a higher VAS pain score on the 1st postoperative day than during the operation night. No group differences in side-effects and complication incidences, functional recovery, and satisfaction were found. This study demonstrates that PMDI provides additional pain relief and reduces opioid consumption only during the early postoperative period in patients managed by the contemporary pain management protocol following TKA.
The Knee 04/2011; 19(4):253-9. · 1.74 Impact Factor
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ABSTRACT: Patient satisfaction is becoming increasingly important as a crucial outcome measure for total knee arthroplasty. We aimed to determine how well commonly used clinical outcome scales correlate with patient satisfaction after total knee arthroplasty. In particular, we sought to determine whether patient satisfaction correlates better with absolute postoperative scores or preoperative to 12-month postoperative changes. Patient satisfaction was evaluated using 4 grades (enthusiastic, satisfied, noncommittal, and disappointed) for 438 replaced knees that were followed for longer than 1 year. Outcomes scales used the American Knee Society, Western Ontario McMaster University Osteoarthritis Index scales, and Short Form-36 scores. Correlation analyses were performed to investigate the relation between patient satisfaction and the 2 different aspects of the outcome scales: postoperative scores evaluated at latest follow-ups and preoperative to postoperative changes. The Western Ontario McMaster University Osteoarthritis Index scales function score was most strongly correlated with satisfaction (correlation coefficient=0.45). Absolute postoperative scores were better correlated with satisfaction than the preoperative to postoperative changes for all scales. Level of evidence: Level IV (retrospective case series).
The Journal of arthroplasty 10/2010; 25(7):1125-30. · 1.79 Impact Factor
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ABSTRACT: This study was conducted (1) to document discrepancies between preoperative and postoperative radiographic measurements and postregistration and postimplantation intraoperative navigational measurements of coronal limb alignments, and (2) to identify predictors of discrepancies between radiographic and navigational measures. In addition, we propose the use of a novel radiographic measuring method, and we demonstrate that this method reduces discrepancies. For 107 total knee arthroplasties performed using a navigation system, coronal alignment were assessed using preoperative and postoperative whole limb radiographs using the standard and novel radiographic methods. During surgery, coronal limb alignment was measured using the navigation system postregistration and postprosthesis implantation. Strengths of correlations and discrepancies between radiographic and navigational assessments were compared between the standard and novel methods. Multivariate regression was performed to identify predictors of discrepancies. Differences between radiographic and navigational measurements were observed for both preoperative and postoperative assessments, but discrepancies were greater for preoperative assessments, despite their stronger correlations. Extent of preoperative varus deformity was identified as the strongest predictor of discrepancy in preoperative radiographic and navigational measurements, and varus malalignment was identified as the strongest predictor of discrepancy in postoperative measurements. Strengths of correlations between radiographic and navigational measurements were similar for the standard and novel radiographic methods, but discrepancies between the 2 were significantly smaller for the novel method for both preoperative and postoperative assessments. The authors propose the use of the described novel radiographic method that reduces discrepancies between radiographic and navigational measurements.
Orthopedics 10/2010; 33(10 Suppl):62-7. · 2.66 Impact Factor
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ABSTRACT: The authors investigated the clinical value of intraoperative periarticular multimodal drug injections (PMDI) in patients on continuous epidural analgesia after simultaneous bilateral TKAs. In 55 patients scheduled to undergo simultaneous bilateral TKAs, one knee was randomly assigned to the PMDI group for which intraoperative periarticular injections were administered and the other knee was assigned to the No-PMDI group for which the injections were not done. These two groups were compared for pain level (during the operation night and on postoperative days (POD) 1, 4, and 7), functional recovery (ability to perform straight leg raising on POD 1 and maximum flexion on POD 7), patient satisfaction (POD 7), and the incidence of wound complications. The PMDI group showed a lower pain level during the operation night and on POD 1 than the No-PMDI group, but no differences in pain levels were observed between the groups on POD 4 or 7. Furthermore, no significant group differences were found in terms of functional recovery, patient satisfaction. No wound complication has been occurred in the PMDI group. This study demonstrates that PMDI provides additional pain relief limited to the immediate postoperative period but does not improve pain relief after POD 1, patient satisfaction and functional recovery.
Knee Surgery Sports Traumatology Arthroscopy 07/2010; 18(7):916-22. · 2.21 Impact Factor
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ABSTRACT: Patient age, radiographic severity of osteoarthritis (OA), and severity of symptoms are typically considered as the three key factors in selecting the osteoarthritic patients for total knee arthroplasty (TKA). The purpose of this study was to evaluate the associations between the three selection criteria and the postoperative outcomes including patient satisfaction. We also attempted to determine whether the patients not fully satisfying the criteria are different from the typical candidates in postoperative outcomes.
Three hundred and eighty-three uncomplicated TKAs with 1-year follow-up data were included in this study. We evaluated three preoperative factors including age, radiographic severity of OA, and WOMAC pain and function scores as proxies of preoperative level of symptoms. Evaluation of the postoperative outcomes included WOMAC pain and function scores and the level of patient satisfaction. Regression analyses were used to investigate the associations between the preoperative factors and the postoperative outcomes. Comparative analyses of the postoperative outcomes were made between the typical candidates with all selection criteria and the groups of patients who did not meet one of the selection criteria.
Increasing age was associated with worse postoperative functional outcomes. Worse preoperative WOMAC pain and function scores were associated with worse postoperative WOMAC pain and function scores, and had a statistical tendency toward higher patient dissatisfaction. Compared to the typical candidates, the groups of patients who did not meet one of the selection criteria did not have worse postoperative outcomes. On the contrary, the group of younger age and the group with less severe preoperative symptoms were more likely to have better postoperative outcomes. The radiographic severity of OA had no significant associations with any of postoperative outcomes.
This study indicates that, when considering TKA as a treatment option, orthopedic surgeons need to comprehend the selection criteria in an overall view to offer the best timing for optimal postoperative outcomes.
Journal of Orthopaedics and Traumatology 02/2010; 11(1):21-7.
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ABSTRACT: While computer assisted total knee arthroplasty (TKA) has been documented to increase the surgical accuracy in the planning process, there is little information about the accuracy in execution processes. We aimed to determine the accuracy of execution processes for bone resections and implant fixation in TKAs performed with the techniques of computer assisted navigation and minimally invasive surgery. Execution deviations, defined as the differences between planned targets and executed results, were evaluated for bone resections and implant fixation in 107 TKAs. In tibia resection, the mean resection thickness, coronal alignment, and sagittal alignment were 0.2mm smaller, 0.3 degrees more valgus, 0.3 degrees less posterior slope than the planned, respectively. In femur resection, the mean resection thicknesses in the medial and lateral femoral condyles, coronal alignment, and sagittal alignment were 0.6mm smaller, 0.8mm smaller, 0.1 degrees more varus, and 0.7 degrees less posterior slope than the planned, respectively. In implant fixation, the mean coronal alignment and degree of extension was 0.7 degrees more valgus and 1.6 degrees decrease than the planned, respectively. Only the occurrence of unacceptable executions in implant fixation had significant effects on the final coronal alignment. The density of a bone and the quality of saw blade had significant effect on the accuracy of bone resections. Execution deviations from planned alignment commonly occur in computer-assisted minimally invasive TKA, resulting typically from the techniques of bone resections and implant fixation, and this information should be considered to improve the surgical accuracy of navigated TKAs.
The Knee 08/2009; 17(1):23-8. · 1.74 Impact Factor
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ABSTRACT: The rotating-platform posterior-stabilized (RP/PS) prosthesis was developed to take advantage of the benefits of the traditional RP mobile-bearing system and the posterior-stabilized design. This nonconsecutive cohort study compared the clinical outcomes of TKAs performed using a RP/PS mobile system or a floating-platform (FP) system. The clinical outcomes of 93 TKAs with a RP/PS prosthesis were compared with the same number of TKAs with a FP mobile-bearing prosthesis at 6, 12, and 24 months after surgery. Clinical outcomes differed between the FP and RP/PS groups as a function of length of followup. In the FP group, most outcomes peaked at 12 months and then deteriorated, whereas in the RP/PS group, outcomes stabilized or continued to improve between 12 and 24 months. The RP/PS group had greater maximum flexion throughout followup and better clinical outcomes 24 months after surgery. Patient satisfaction was superior in the RP/RS group. This study suggests the RP/PS prosthesis provides better functional outcomes, including greater maximum flexion and better patient satisfaction. We propose the RP/PS mobile-bearing system is a more attractive option than the FP mobile-bearing system for patient populations of elderly women similar to patients enrolled in our study.
Clinical Orthopaedics and Related Research 04/2009; · 2.53 Impact Factor
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ABSTRACT: In computer-assisted TKA, surgeons determine positioning of the femoral component in the sagittal plane based on the sagittal mechanical axis identified by the navigation system. We hypothesized mechanical and distal femoral axes may differ on lateral views and these variations are influenced by anteroposterior bowing and length of the femur. We measured angles between the mechanical axis and distal femoral axis on 200 true lateral radiographs of the whole femur from 100 adults. We used multivariate linear regression to identify predictors of differences between the axes. Depending on the method used to define the two axes, the mean angular difference between the axes was as much as 3.8° and as little as 0.0°, with standard differences ranging from 1.7° to 1.9°. Variation between the two axes increased with increased femoral bowing and increased femoral length. Surgeons should consider differences between the mechanical axes and distal femoral axes when they set the sagittal plane position of a femoral component in navigated cases. Our findings also may be relevant when measuring rotation of the femoral component in the sagittal plane from postoperative radiographs or when interpreting femoral component sagittal rotation results reported in other studies.
Clinical Orthopaedics and Related Research 03/2009; · 2.53 Impact Factor
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ABSTRACT: This study was conducted to investigate functional disabilities and patient satisfaction in Korean patients after total knee arthroplasty (TKA). Of 372 female patients who had undergone TKA with a follow-up longer than 12 months, 261 patients (70.2%) completed a questionnaire designed to evaluate functional disabilities, perceived importance, and patient satisfaction. The top 5 severe functional disabilities were difficulties in kneeling, squatting, sitting with legs crossed, sexual activity, and recreational activities. The top 5 in order of perceived importance were difficulties in walking, using a bathtub, working, recreation activities, and climbing stairs. Severities of functional disabilities were not found to be correlated with perceived importance. The 23 patients (8.8%) dissatisfied with their replaced knees had more severe functional disabilities than the patients satisfied for most activities. The dissatisfied patients tended to perceive functional disabilities in high-flexion activities to be more important than the satisfied.
The Journal of arthroplasty 03/2009; 25(3):458-464.e1-2. · 1.79 Impact Factor
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ABSTRACT: This study examined whether or not nonresponders to mail survey have poorer clinical outcomes than responders. A postal questionnaire, which was designed to evaluate the functional disability and patient's satisfaction, was mailed to 387 patients whose 1-year clinical outcomes were available. Of the 270 patients (69.8%) who responded, 247 (91.4%) reported that they were satisfied with their replaced knees. The knees of the nonresponders showed significantly poorer results in terms of the function-related scales (American Knee Society score function, Western Ontario McMaster University Osteoarthritis Index scale function, Short-Form 36 physical and functional scores) than the knees of the responders, whereas there were no significant differences in the pain-related scales. The clinical results of the nonresponders were poorer in most of the clinical outcome scales than those of the satisfied subgroup of responders but better than those of the dissatisfied subgroup. The results of the pain-related scales were similar to the satisfied subgroup but the function-related scales were similar to the dissatisfied subgroup.
The Journal of arthroplasty 01/2009; 25(1):133-7. · 1.79 Impact Factor
