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Patient-reported outcomes and component rotation in total knee replacement: a prospective, observational study in 498
Hans-Peter van Jonbergen1, Stefan Gelderman2, Ellie Landman3
1Orthopedic Surgery, Deventer Hospital, Deventer, The Netherlands vanjonbergen@dz.nl.
Objectives:
To assess the relation between component rotation in total knee replacement and clinical outcomes.
Design:
Prospective, observational cohort study.
Setting:
Deventer hospital, Deventer, The Netherlands.
Participants:
498 adults aged 18 years and older undergoing total knee replacement.
Interventions:
Participants underwent Persona posterior stabilised total knee replacement. Femoral and tibial component rotation was measured using low-dose CT scans.
Main Outcome Measures:
The primary outcome was the change in Oxford Knee Score from baseline to 1 year, analysed in relation to femoral, tibial and combined component rotation.
Results:
Binary logistic regression analysis showed no statistically significant association between femoral component rotation (OR=1.04, 95% CI 0.89 to 1.21, p=0.644), tibial component rotation (OR=0.99, 95% CI 0.94 to 1.03, p=0.467), or combined rotation (OR=0.99, 95% CI 0.95 to 1.03, p=0.552), and achievement of the minimal clinically important difference of 5 points for the 48-point Oxford Knee Score.
Conclusions:
This prospective study of 498 patients undergoing total knee replacement did not provide evidence of a relation between the rotational alignment of total knee arthroplasty components and clinical outcomes. These findings do not support routine evaluation of rotational alignment as a basis for revision surgery in patients with persistent pain in the absence of mechanical problems.
Trial Registration Number:
Dutch Trial registry ID: 23362.
