J Korean Orthop Assoc.  2013 Feb;48(1):1-8. 10.4055/jkoa.2013.48.1.1.

The Effect of a Lumbar Spinal Lesion on the Clinical Results of Total Knee Arthroplasty

• Cho WS
• Byun SE
• Yoon YS
• Sun JH

• KMID: 2106656
• DOI: http://doi.org/10.4055/jkoa.2013.48.1.1

Abstract

PURPOSE
Patients with osteoarthritis of knee joint often concomitantly suffer from degenerative disease of the spine. Furthermore, resulting spinal problems could influence function and pain after total knee arthroplasty (TKA), and hence, cause the results of TKA to be misinterpreted. The purpose of this prospective study was to evaluate the effect of spinal disorders, as assessed by Swiss Spinal Stenosis score (SSS scores), on knee function as assessed by knee scores, the Hospital for Special Surgery scale (HSS scale) and Western Ontario & McMaster Osteoarthritis Index scores (WOMAC scores) in patients that after TKA.
MATERIALS AND METHODS
One hundred and forty nine osteoarthritic knees of 87 patients were enrolled in this study. All patients received TKA by single surgeon (W-S Cho) from August 2009 to May 2010. Preoperative and postoperative 1- and 2-years HSS scale, Knee, WOMAC, and SSS scores were recorded and analyzed.
RESULTS
Postoperative HSS scale, Knee, and WOMAC scores showed marked improvements versus preoperative scores, and scores at 2 years postoperatively were better than at 1 year postoperatively. No significant correlation was found between postoperative Knee scores and SSS scores. On the other hand, statistically significant correlations were found between HSS and SSS scores and between WOMAC and SSS scores. Interestingly, differences between Knee scores and HSS scores were found to be significantly correlated with SSS scores.
CONCLUSION
When evaluating outcome after TKA, spinal problems should be investigated concomitantly. SSS scores appear to provide a suitable means of assessing spinal problems.

Keyword

total knee arthroplasty; Hospital for Special Surgery scale; knee score; Western Ontario & McMaster Osteoarthritis Index score; Swiss Spinal Stenosis score

MeSH Terms

Arthroplasty
Hand
Humans
Joints
Knee
Ontario
Osteoarthritis
Osteoarthritis, Knee
Prospective Studies
Spinal Stenosis
Spine

Figure

• 

  Figure 1 Plots of clinical scores versus SSS scores at 2 years after surgery. (A) Graph showing a significant correlation between HSS scale and SSS scores. (B) Graph showing no significant correlation between KS and SSS scores. (C) Graph showing a significant correlation between KS minus HSS scale scores and SSS scores. (D) Graph showing a significant correlation between WOMAC scores and SSS scores. SSS score, Swiss Spinal Stenosis score; HSS scale, Hospital for Special Surgery scale; KS, knee scores; WOMAC score, Western Ontario & McMaster Osteoarthritis Index score.

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