Coronal tibiofemoral subluxation is not an independent risk factor for total knee arthroplasty in patients with moderate to severe varus-osteoarthritis: data from the "Osteoarthritis Initiative".

Abstract:

PURPOSE:Only few prognostic factors for progression of knee osteoarthritis are well established, including varus malalignment. The purpose of this study was to evaluate whether coronal tibiofemoral subluxation is a predictor for total knee arthroplasty. METHODS:Patients from the progression subcohort of the longitudinal database "Osteoarthritis Initiative" with moderate to severe osteoarthritis and varus malalignment of greater than 3 degrees were included. Patients who underwent total knee arthroplasty were matched with patients treated conservatively. Subluxation was measured on full limb length X-rays. Cox regression analysis was performed to retrospectively evaluate subluxation as a risk factor for total knee arthroplasty and check for a possible association between subluxation and pain at the beginning of the observation period in this study. RESULTS:A total of 215 patients were included. Cox regression demonstrated that varus malalignment increased the hazard to undergo surgery by 16% (HR 1.158, p = 0.008) while subluxation did not (HR 1.12, p = 0.11). Furthermore, subluxation was neither associated with poor WOMAC (OR 1.13, p = 0.194) nor KOOS (OR 1.11, p = 0.256) knee pain scores at the beginning of the observation period. CONCLUSION:The results presented show that subluxation is neither an independent risk factor for total knee arthroplasty, nor for poor pain scores. LEVEL OF EVIDENCE:III.

authors

Schadler P,Kasparek M,Boettner F,Sgroi M,Faschingbauer M

doi

10.1007/s00402-017-2777-9

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

1423-1428

issue

10

eissn

0936-8051

issn

1434-3916

pii

10.1007/s00402-017-2777-9

journal_volume

137

pub_type

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