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
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摘要Introduction: 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.
著者Gloria Yan-Ting Lam, Tsz Lung Choi, Jonathan Patrick Ng, Michael Tim-Yun Ong, Patrick Shu-Hang Yung
會議名稱The HKOA 43rd Annual Congress of The Hong Kong Orthopaedic Association
會議開始日04.11.2023
會議完結日05.11.2023
會議地點Hong Kong
會議國家/地區香港
出版年份2023
月份11
出版社Hong Kong Academy of Medicine Press
出版地Hong Kong
頁次25 - 25
語言美式英語
