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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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TKR after posttraumatic and primary knee osteoarthritis: a comparative study.

Ong-Art Phruetthiphat1, Biagio Zampogna2, Sebastiano Vasta2

  • 1Department of Orthopedics, Phramongkutklao Hospital and College of Medicine, 315 Ratchvidhi Road, Ratchathewee, Bangkok, 10400, Thailand. ongart-phr1@hotmail.com.

Journal of Orthopaedic Surgery and Research
|March 5, 2021
PubMed
Summary

Total knee replacement (TKR) outcomes in fracture posttraumatic osteoarthritis (PTOA) were poorer than primary osteoarthritis (OA). Ligamentous PTOA showed no difference, and mechanical axis did not impact 8-year survival in this TKR study.

Keywords:
Aseptic looseningComplicationFunctional outcomeMechanical alignmentPosttraumatic knee osteoarthritisPrimary knee osteoarthritisTotal knee replacement

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Clinical Research

Background:

  • Literature suggests total knee replacement (TKR) outcomes are poorer in posttraumatic osteoarthritis (PTOA) compared to primary osteoarthritis (primary OA).
  • This study investigates comorbidities and outcomes of TKR in fracture PTOA, ligamentous PTOA, and primary OA.
  • A secondary aim is to assess the effect of postoperative mechanical axis on 8-year TKR survivorship in PTOA versus primary OA.

Purpose of the Study:

  • To compare comorbidity and TKR outcomes among fracture PTOA, ligamentous PTOA, and primary OA.
  • To evaluate the influence of lower limb mechanical axis on 8-year TKR survivorship in PTOA and primary OA patients.

Main Methods:

  • Retrospective cohort study including 716 primary OA patients, 32 fracture PTOA patients, and 104 ligamentous PTOA patients.
  • Comparison of demographics, comorbidities (CCI), operative parameters, mechanical axis, WOMAC functional outcomes, and complications.
  • Level III evidence.

Main Results:

  • PTOA patients were younger and had a higher male proportion; primary OA patients had more comorbidities.
  • Fracture and ligamentous PTOA groups had longer operative times than primary OA.
  • Fracture PTOA showed lower pain and stiffness, but no significant difference in 8-year survivorship or mechanical axis alignment was found between PTOA and primary OA groups.

Conclusions:

  • TKR outcomes in fracture PTOA are poorer than primary knee OA at midterm follow-up.
  • No significant difference in TKR outcomes was observed between ligamentous PTOA and primary knee OA.
  • Mechanical axis alignment did not affect 8-year TKR survivorship in either PTOA or primary OA.