A Prospective Study of Functional Outcome of Total Knee Arthroplasty in Kellgren-Lawrence Grade IV Osteoarthritis

Knee osteoarthritis (OA) is a major contributor to disability globally, especially among older adults. Kellgren-Lawrence (K-L) Grade IV OA signifies the advanced stage of the disease, where non-surgical treatments fail. Total knee arthroplasty (TKA) is the preferred surgical option, though results can differ based on patient characteristics and clinical variables.

The study aimed to prospectively assess the functional outcomes of TKA in patients with K-L Grade IV OA using the Oxford Knee Score (OKS).

This prospective observational study involved 50 patients undergoing initial TKA at LN Medical College, Bhopal. Data on demographics, pre-surgery deformities, duration of hospital stay, and complications were collected. Functional outcomes were measured using OKS at the start, and then 3, 6, and 9 months after surgery. Statistical analysis was conducted with paired t-tests, considering P < 0.05 as significant.

Most participants were women (64%), aged between 61 and 65, and were overweight or obese (76%). Varus deformity was the most common pre-operative condition (60%), with 36% having a fixed flexion deformity. The average hospital stay was 8.2 ± 1.5 days. Minor complications included wound infections (6%) and stiffness (4%), with no significant implant failures. The average OKS increased significantly from 18.4 ± 3.2 before surgery to 40.1 ± 2.9 at 9 months post-surgery (P < 0.001), indicating a 118% improvement.

TKA significantly enhances function in patients with Grade IV knee OA, correcting deformities and improving quality of life with few complications. These results align with global studies, confirming TKA as the definitive solution for advanced knee OA.