Document Detail

Patient-reported outcome and survivorship after Kinemax total knee arthroplasty.
MedLine Citation:
PMID:  15523019     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We examined the long-term survivorship and patient-reported outcomes at a minimum of ten years following primary total knee arthroplasty. We hypothesized (1) that the survival rate would be at least 90% at ten years; (2) that age, gender, body-mass index, and primary diagnosis would not affect the survival rate; and (3) that the functional status of patients would be comparable with that of an age and gender-matched normal population. METHODS: A total of 407 patients (523 knees) who had had primary total knee arthroplasty between January 1988 and April 1991 were identified. The mean age of the patients at the time of surgery was sixty-nine years, and 68% of the patients were women. At ten years, 165 patients (211 knees) had died; seven of these 211 knees had been revised before the time of death. Of the remaining 242 patients, 208 (86%) completed a questionnaire, which included the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), the Short Form-36 (SF-36), and questions regarding patient satisfaction and revision surgery. In the group of patients who participated in the study, ten patients (eleven knees) had had a revision before the review. RESULTS: A total of eighteen knees were revised. Twelve knees were revised because of aseptic failure and, of these, nine were revised because of polyethylene wear. The probability of survival at ten years was 96.1% with revision for any reason as the end point (and 97.2% when only aseptic failures were considered). Because of the small number of failures, we were unable to draw conclusions about associations between failure and age, gender, diagnosis, and body-mass index. The mean WOMAC scores (and standard deviation) at the time of the evaluation were 88 +/- 17 for pain and 79 +/- 20 for function. The SF-36 scores were similar to those for an age and gender-matched normal population, with only the physical functioning score being significantly lower (p < 0.001) and with the general health score being significantly higher (p < 0.001). Patients generally were very satisfied with all aspects of the outcome. CONCLUSIONS: At ten years, the survival of the prosthesis was excellent and the majority of patients were functionally independent, had very little knee pain, and were very satisfied with the result. The health benefits of this total knee arthroplasty were maintained after a minimum duration of follow-up of ten years.
R John Wright; Clement B Sledge; Robert Poss; Frederick C Ewald; Maureen E Walsh; Elizabeth A Lingard
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  86-A     ISSN:  0021-9355     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-11-03     Completed Date:  2004-12-21     Revised Date:  2010-10-25    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2464-70     Citation Subset:  AIM; IM    
Department of Orthopedic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
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MeSH Terms
Activities of Daily Living
Arthroplasty, Replacement, Knee*
Follow-Up Studies
Knee Prosthesis*
Prosthesis Failure
Quality of Life
Survival Analysis
Treatment Outcome

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