Achieving Minimum Clinically Important Difference in Oxford Knee Score and Short Form-36 Physical Component Summary Is Less Likely with Single-Radius Compared with Multiradius Total Knee Arthroplasty in Asians

Wu Chean Lee; Hamid Rahmatullah Bin Abd Razak; John Carson Allen; Hwei Chi Chong; Hwee Chye Andrew Tan

doi:10.1055/s-0038-1641139

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2019; 32(03): 227-232
DOI: 10.1055/s-0038-1641139

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Achieving Minimum Clinically Important Difference in Oxford Knee Score and Short Form-36 Physical Component Summary Is Less Likely with Single-Radius Compared with Multiradius Total Knee Arthroplasty in Asians

Wu Chean Lee

¹Department of Orthopaedic Surgery, Singapore General Hospital, Singapore

,

Hamid Rahmatullah Bin Abd Razak

¹Department of Orthopaedic Surgery, Singapore General Hospital, Singapore

,

John Carson Allen

²Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore

,

Hwei Chi Chong

³Orthopaedic Diagnostic Centre, Singapore General Hospital, Singapore

,

Hwee Chye Andrew Tan

¹Department of Orthopaedic Surgery, Singapore General Hospital, Singapore

› Author Affiliations

Abstract

Single-radius (SR) and multiradius (MR) total knee arthroplasties (TKAs) have produced similar outcomes, albeit most studies originate from Western nations. There are known knee kinematic differences between Western and Asian patients after TKA. The aim of this study is to compare the short-term patient-reported outcome measures (PROMs) of SR-TKA versus MR-TKA in Asians. Registry data of 133 SR-TKA versus 363 MR-TKA by a single surgeon were analyzed. Preoperative and 2-year postoperative range of motion (ROM) and PROMs were compared with Student's t-test and Mann–Whitney U-test. Logistic regression model was used to evaluate the odds of SR-TKA or MR-TKA achieving the minimum clinically important difference (MCID) of studied outcomes. Patients in both groups had similar age (65.7 ± 7.6 vs. 65.8 ± 8.2 years; p = 0.317), gender proportion (71% females vs. 79% females; p = 0.119), and ethnic distribution (80% Chinese vs. 84% Chinese; p = 0.258). Preoperatively, there were no statistically significant differences between both groups for ROM, Knee Society Score (KSS), Oxford Knee Score (OKS), and Short Form (SF)-36 scores. At 2 years, all outcomes were statistically similar or failed to achieve a difference of MCID. Controlling for all preoperative variables, SR-TKA has significantly lower odds of achieving MCID for OKS (odds ratio [OR]: 0.275, 95% confidence interval [CI]: 0.114–0.663; p = 0.004) and SF-36 Physical Component Summary (PCS) (OR: 0.547; 95% CI: 0.316–0.946; p = 0.031) compared with MR-TKA. In conclusion, there are no significant differences in the absolute PROMs between SR-TKA and MR-TKA at 2 years following TKA in Asians. However, SR-TKA has significantly lower odds of achieving the MCID for OKS and SF-36 PCS.

Keywords

total knee arthroplasty - single radius - multiradius - Asians - minimum clinically important difference

Full Text

References

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