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Gelenkfunktion nach bikondylärer Knieendoprothese

Unterschiedlicher Verlauf bei Patienten mit Gonarthrose und rheumatoider Arthritis

Recovery of knee function after total knee arthroplasty

Different outcomes in patients with osteoarthritis and rheumatoid arthritis

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Zusammenfassung

Hintergrund

Mögliche Unterschiede zwischen Patienten mit rheumatoider Arthritis (RA) und Gonarthrose (OA) bezüglich der rein subjektiven Einschätzung der Gelenkfunktion nach totaler Endoprothese (TEP) des Knies sind bis dato nicht untersucht.

Material und Methoden

Prospektive klinische Studie mit 128 konsekutiv erfassten Patienten (OA: n = 92; RA: n = 36) mit der Indikation zur hybriden bikondylären Knie-TEP. Die Kniefunktion wurde präoperativ (T0) und nach 6 Monaten (T1) und 12 Monaten (T2) mittels Knee Injury and Osteoarthritis Outcome Score (KOOS) und Oxford Knee Score (OKS) erfasst.

Ergebnisse

OKS und KOOS zeigen eine statistisch signifikante Verbesserung für die OA- und RA-Patientenkohorte bei T1 (6 Monate) und T2 (12 Monate), verglichen mit T0 (präoperativ). Die OKS-Werte von T1 und T2 zeigte keinen statistisch signifikanten Unterschied für beide Subgruppen. Der KOOS ergab in der OA-Kohorte eine statistisch signifikante Verbesserung zwischen T1 und T2 bezüglich des Gesamt-Scores und aller Unterpunkte, nicht jedoch in der RA-Gruppe.

Schlussfolgerung

Während bei OA-Patienten mit einer Besserung der Kniefunktion bis zu 12 Monate nach Implantation zu beobachten ist, zeigen RA-Patienten zwischen 6 und 12 Monaten postoperativ keine weitere Verbesserung, wenn die Kniefunktion mittels patientenzentrierter Erfassungsmethoden ausgewertet wird.

Abstract

Introduction

Following total knee arthroplasty (TKA), no investigations have been published to assess possible differences between rheumatoid arthritic (RA) and osteoarthritic (OA) patients with respect to patient-reported outcome measures of knee function.

Patients and methods

A cohort of 128 consecutively operated patients (OA: n = 92, RA: n = 36) treated with bicondylar TKA was included in this prospective, clinical study. Knee function was assessed preoperatively and at 6 and 12 months after TKA, using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Oxford Knee Score (OKS).

Results

Both OKS and KOOS revealed a statistically significant improvement for OA and RA patients at 6 and 12 months after surgery, as compared to the preoperative status. The results of the OKS at 6 and 12 months did not show a further improvement for either group. The KOOS, however, revealed an additional improvement between 6 and 12 months for the osteoarthritis group, regarding the total score and all subscores, but not for the RA subgroup.

Conclusion

Functional recovery after TKA improves in the second 6 months after surgery in OA patients, but not in RA patients, when knee function is exclusively assessed with patient-reported outcome measures.

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Literatur

  1. Aletaha D, Neogi T, Silman AJ et al (2010) Rheumatoid arthritis classification criteria. An American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62(9):2569–2581

    Article  PubMed  Google Scholar 

  2. Asif S, Choon DS (2005) Midterm results of cemented press fit condylar sigma total knee arthroplasty system. J Orthop Surg (Hong Kong) 13(3):280–284

    Google Scholar 

  3. Avramidis K, Karachalios T, Popotonasios K et al (2011) Does electric stimulation of the vastus medialis muscle influence rehabilitation after total knee replacement? Orthopedics 34(3):175

    PubMed  Google Scholar 

  4. Bade MJ, Stevens-Lapsley JE (2011) Early high-intensity rehabilitation following total knee arthroplasty improves outcomes. J Orthop Sports Phys Ther 41(12):932–941

    Article  PubMed  Google Scholar 

  5. Bade MJ, Stevens-Lapsley JE (2012) Restoration of physical function in patients following total knee arthroplasty: an update on rehabilitation practices. Curr Opin Rheumatol 24:208–214

    Article  PubMed  Google Scholar 

  6. Bisschop R, Brouwer RW, Van Raay JJ (2010) Total knee arthroplasty in younger patients: a 13-year follow-up study. Orthopedics 33:876

    PubMed  Google Scholar 

  7. Bistolfi A, Massazza G, Rosso F et al (2011) Cemented fixed-bearing PFC total knee arthroplasty: survival and failure analysis at 12–17 years. J Orthop Traumatol 12(3):131–136

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Browne JP, Bastaki H, Dawson J (2013).What is the optimal time point to assess patient-reported recovery after hip and knee replacement? A systematic review and analysis of routinely reported outcome data from the English patient-reported outcome measures programme. Health Qual Life Outcomes 11:128

    Article  PubMed Central  PubMed  Google Scholar 

  9. Dahl A, Toksvig-Larsen S, Roos EM (2005) A 2-year prospective study of patient-relevant outcomes in patients operated on for knee osteoarthritis with tibial osteotomy. BMC Musculoskelet Disord 6:18

    Article  Google Scholar 

  10. Kessler S, Lang S, Puhl W, Stöve J (2003) The knee injury and osteoarthritis outcome score – a multifunctional questionnaire to measure outcome in knee arthroplasty. Z Orthop Ihre Grenzgeb 141:277–282

    Article  CAS  PubMed  Google Scholar 

  11. Groot IB de, Favejee MM, Reijman M et al (2008) The Dutch version of the knee injury and osteoarthritis outcome score: a validation study. Health Qual Life Outcomes 6:16–22

    Article  PubMed Central  PubMed  Google Scholar 

  12. Kellgren JH, Lawrence JS (1957) Radiological assessment of osteoarthrosis. Ann Rheum Dis 16(4):494–502

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Kellgren JH, Lawrence JS (1957) Radiological assessment of rheumatoid arthritis. Ann Rheum Dis 16(4):485–493

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Larsen A, Dale K, Eek M (1977) Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn (Stockh) 18(4):481–491

    Google Scholar 

  15. Muldoon MF, Barger SD, Flory JD, Manuck SB (1998) What are quality of life measurements measuring? BMJ 316(7130):542–545

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Munk S, Dalsgaard J, Bjerggaard K et al (2012) Early recovery after fast-track Oxford unicompartmental knee arthroplasty. 35 patients with minimal invasive surgery. Acta Orthop 83(1):41–45

    Article  PubMed Central  PubMed  Google Scholar 

  17. Munk S, Odgaard A, Madsen F et al (2011) Preoperative lateral subluxation of the patella is a predictor of poor early outcome of Oxford phase-III medial unicompartmental knee arthroplasty. Acta Orthop 82(5):582–588

    Article  PubMed Central  PubMed  Google Scholar 

  18. Neogi T, Aletaha D, Silman AJ et al (2010) American College of Rheumatology; European League Against Rheumatism The 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for rheumatoid arthritis: Phase 2 methodological report. Arthritis Rheum 62(9):2582–2591

    Article  PubMed Central  PubMed  Google Scholar 

  19. Nerhus TK, Heir S, Thornes E et al (2010) Time-dependent improvement in functional outcome following LCS rotating platform knee replacement. Acta Orthop 81(6):727–732

    Article  PubMed Central  PubMed  Google Scholar 

  20. Nerhus TK, Heir S, Svege I et al (2012) Time-dependent improvement in functional outcome following Oxford medial unicompartmental knee arthroplasty. A prospective longitudinal multicenter study involving 96 patients. Acta Orthop 83(1):46–52

    Article  PubMed Central  PubMed  Google Scholar 

  21. Nilsdotter AK, Toksvig-Larsen S, Roos EM (2009) Knee arthroplasty: are patients‘ expectations fulfilled? A prospective study of pain and function in 102 patients with 5-year follow-up. Acta Orthop 80(1):55–61

    Article  PubMed Central  PubMed  Google Scholar 

  22. Paddison C (o J) Why we need more patient involvement in the commissioning of health services. Cambridge Center for Health Services Research. http://www.cchsr.iph.cam.ac.uk/844

  23. Naal FD, Impellizzeri FM, Sieverding M et al (2009) The 12-item Oxford Knee Score: cross-cultural adaptation into German and assessment of its psychometric properties in patients with osteoarthritis of the knee. Osteoarthritis Cartilage 17:49–52

    Article  CAS  PubMed  Google Scholar 

  24. Petterson SC, Mizner RL, Stevens JE et al (2009) Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort. Arthritis Rheum 61(2):174–183

    Article  PubMed  Google Scholar 

  25. Price AJ, Rees JL, Beard D et al (2003) A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. A multicentre single-blind randomized controlled trial. J Bone Joint Surg Br 85(1):62–67

    Article  CAS  PubMed  Google Scholar 

  26. Roos EM, Toksvig-Larsen S (2003) Knee injury and Osteoarthritis Outcome Score (KOOS) – validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes 1:17–23

    Article  PubMed Central  PubMed  Google Scholar 

  27. Singh JA, Lewallen DG (2013) Better functional and similar pain outcomes in osteoarthritis compared to rheumatoid arthritis after primary total knee arthroplasty: a cohort study. Arthritis Care Res (Hoboken) (Epub ahead of print)

  28. Sloan FA, George LK, Hu L (2013) Improvements in physical functioning of TKA recipients persisted in this longer term analysis of outcome in a nationally representative population study. J Aging Health (Epub ahead of print)

  29. Viganó R, Whiteside LA, Roy M (2008) Clinical results of bone ingrowth TKA in patients with rheumatoid arthritis. Clin Orthop Relat Res 466:3071–3077

    Article  PubMed Central  PubMed  Google Scholar 

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Einhaltung ethischer Richtlinien

Interessenkonflikt. H.-D. Carl, L. Reiss, J. Stolle und B. Swoboda geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag enthält keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Abteilung für Orthopädische Rheumatologie, FAU Erlangen-Nürnberg im Waldkrankenhaus St. Marien, Rathsberger Str. 57, 91054, Erlangen, Deutschland

    L. Reiss, J. Stolle,  H.-D. Carl & B. Swoboda

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  1. L. Reiss
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  2. J. Stolle
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Correspondence to H.-D. Carl.

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Reiss, L., Stolle, J., Carl, HD. et al. Gelenkfunktion nach bikondylärer Knieendoprothese. Z. Rheumatol. 73, 559–564 (2014). https://doi.org/10.1007/s00393-013-1291-x

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  • DOI: https://doi.org/10.1007/s00393-013-1291-x

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