Posterior condylar offset is an independent predictor of functional outcome after revision total knee replacement

Nicholas Clement (Lead Author), Deborah MacDonald, David Hamilton, Richard Burnett

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives Preservation of posterior condylar offset (PCO) has been demonstrated to correlate with improved functional results after primary total knee replacement (TKR). Whether this is also the case for revision TKR remains unknown. The aim of this study was to assess the independent effect of PCO on early functional outcome after revision TKR. Method One hundred and seven consecutive aseptic revision TKRs were performed by a single surgeon during an eight year period. The mean age was 69.4 (range 39 to 85) years and there were 59 female patients and 48 male patients. The Oxford knee score (OKS) and Short form (SF-12) score were assessed pre-operatively and one year postoperatively. Patient satisfaction was also assessed at one year. Joint line and PCO were assessed radiographically at one year. Results There was a significant improvement in the OKS (10.6 points, 95% confidence interval (CI) 8.8 to 12.3) and the SF-12 physical component score (5.9, 95% CI 4.1 to 7.8). PCO directly correlated with change in OKS (p<0.001). Linear regression analysis confirmed the independent effect of PCO on the OKS (p<0.001) and the SF-12 physical score (p=0.02). The overall rate of satisfaction was 85% and on logistic regression analysis improvement in the OKS (p=0.002) was a significant predictor of patient satisfaction, which is related to PCO although this was not independently associated with satisfaction. Conclusion Preservation of PCO should be a major consideration when undertaking revision TKR, and potentially increasing this to balance the flexion gap while maintaining joint line should be assessed intraoperatively.
Original languageEnglish
Pages (from-to)172-178
Number of pages7
JournalBone & Joint Research
Volume6
Issue number3
Early online date30 Mar 2017
DOIs
Publication statusE-pub ahead of print - 30 Mar 2017

Keywords

  • Knee-arthroplasty
  • condylar offset
  • outcome
  • revision

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