Functional impact of joint line obliquity and left-right symmetry in patients with Oxford unicompartmental knee arthroplasty (OUKA)
Refereed conference paper presented and published in conference proceedings
CUHK Authors
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AbstractIntroduction: Post-operative joint line tilting >3° in OUKA was known to be associated with poor functional outcome. However, the effect of left-right joint line symmetry in bilateral OUKAs is still largely unknown.
Methods: Radiological analysis was conducted for patients who received unilateral or bilateral OUKA in Alice Ho Miu Ling Nethersole Hospital from year 2018 to 2021. Joint line obliquity angle (JLOA) was measured in post-operative standing anteroposterior X-rays. Total knee arthroplasties (TKA) were performed in those patients with unilateral OUKA.
Results: 73 patients were reviewed with 100 OUKAs performed. 60 knees were involved in bilateral OUKAs while 40 knees were involved in unilateral TKA and OUKA. 22 knees (22%) had symmetrical JLOA while 26 patients (26%) had bilateral JLOA difference ≥3 degrees. Mean postoperative JLOA was -1.98°±2.94° (medially tilted) and mean left-right (L-R) difference was 2.79°±2.55°. OUKAs with JLOA >3° had less improvement in Knee Society Functional Score (KSFS) than JLOA ≤3° (22.6 vs 31.7, p=0.006). Comparing the group with JLOA symmetry (=0° L-R difference), any asymmetry in JLOA (>0° L-R difference) would have worse Oxford Knee Score (OKS) improvement post-operatively (15.6 vs 20.9, p=0.01). And the degree of L-R asymmetry of JLOA was also moderately correlated with worse OKS improvement (r=0.397, p=0.0001).
Discussion and Conclusion: In bilateral OUKAs, maintaining JLOA<3° and achieving left-right symmetry are essential to maximize the post-operative improvement of functional outcomes.
Methods: Radiological analysis was conducted for patients who received unilateral or bilateral OUKA in Alice Ho Miu Ling Nethersole Hospital from year 2018 to 2021. Joint line obliquity angle (JLOA) was measured in post-operative standing anteroposterior X-rays. Total knee arthroplasties (TKA) were performed in those patients with unilateral OUKA.
Results: 73 patients were reviewed with 100 OUKAs performed. 60 knees were involved in bilateral OUKAs while 40 knees were involved in unilateral TKA and OUKA. 22 knees (22%) had symmetrical JLOA while 26 patients (26%) had bilateral JLOA difference ≥3 degrees. Mean postoperative JLOA was -1.98°±2.94° (medially tilted) and mean left-right (L-R) difference was 2.79°±2.55°. OUKAs with JLOA >3° had less improvement in Knee Society Functional Score (KSFS) than JLOA ≤3° (22.6 vs 31.7, p=0.006). Comparing the group with JLOA symmetry (=0° L-R difference), any asymmetry in JLOA (>0° L-R difference) would have worse Oxford Knee Score (OKS) improvement post-operatively (15.6 vs 20.9, p=0.01). And the degree of L-R asymmetry of JLOA was also moderately correlated with worse OKS improvement (r=0.397, p=0.0001).
Discussion and Conclusion: In bilateral OUKAs, maintaining JLOA<3° and achieving left-right symmetry are essential to maximize the post-operative improvement of functional outcomes.
All Author(s) ListGloria Yan-Ting Lam, Tsz Lung Choi, Jonathan Patrick Ng, Michael Tim-Yun Ong, Patrick Shu-Hang Yung
Name of ConferenceThe HKOA 43rd Annual Congress of The Hong Kong Orthopaedic Association
Start Date of Conference04/11/2023
End Date of Conference05/11/2023
Place of ConferenceHong Kong
Country/Region of ConferenceHong Kong
Year2023
Month11
PublisherHong Kong Academy of Medicine Press
Place of PublicationHong Kong
Pages25 - 25
LanguagesEnglish-United States
