Correlation of post-operative anterior knee pain in two different total knee arthroplasty techniques: the conventional instrumentation (CI) and the patient specific instrumentation (PSI).

  • N. Salamalikis
  • A. Panagopoulos
  • I. Vlamis
  • A. Kotsirakis
  • D. Pappadopoulos
  • J. Boehnke
  • H. Richter
  • I.A. Dontas
  • I. K. Triantafyllopoulos
Keywords: total knee arthroplasty, anterior knee pain, patient specific instrumentation, visual analog scale, Tegner - Lysholm Score, Knee Society Score

Abstract

Purpose: Evaluation of the clinical outcome, as assessed by the Visual Analogue Scale score and clinical questionnaires, in total knee arthroplasty undertaken with patient specific or conventional instrumentation.

Methods: This is a prospective comparative clinical study of 115 consecutive patients who underwent total knee arthroplasty in two different orthopedic centers. Patients were assessed using the 0-10 Visual Analog Scale in different activities, the Tegner -Lysholm Functional Score, the Knee Society Scores (KSS), measured preoperatively and at 3-6-12 months postoperatively.

Results: Both groups improved significantly over time on all score clinical outcomes. Statistically significant differences were observed between the two groups in the KSS knee score postoperatively at 6 and 12 months (p=0.007 and p=0.004 respectively), and in the Tegner- Lysholm score only at 6 months postoperatively (p=0.001), both in favour of patient specific intrumentation group. The mean KSS was 91.32±4.29 and 93.15±4.72 for the conventional and patient specific groups respectively at 12 months follow up (p=0.063). No statistically significant difference was found at 12 months between two groups when the visual analog scale was measured related to the activity of standing up from the sitting position (conventional group: 1.15±0.36   versus patient specific: 1.10±0.30, p=0.380).

Conclusion: We did not find major significant differences for pain scores, functional scores and clinical outcomes between the conventional instrumentation and the use of patient specific instrumentation for total knee replacement. The current literature does not suggest patient specific instrumentation techniques as a gold standard. Therefore, patient specific techniques cannot be recommended as a standard procedure and specially in order to minimize the anterior knee pain after total knee arthroplasty.

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Author Biographies

N. Salamalikis

Orthopaedic Department, 251 Airforce General Hospital, Athens, Greece

Klinikum Niederlausitz GmbH, Klinik für Unfallchirurgie und Orthopädie, Hand und Plastische Chirurgie, Standort Senftenberg, Germany

A. Panagopoulos

Orthopaedic Department, University Hospital of Patras, Patras, Greece

I. Vlamis

Laboratory for Research of the Musculoskeletal System, KAT Hospital, Medical School, National and Kapodistrian University of Athens, Greece

A. Kotsirakis

Orthopaedic Department, 251 Airforce General Hospital, Athens, Greece

D. Pappadopoulos

Orthopaedic Department, 251 Airforce General Hospital, Athens, Greece

J. Boehnke

Klinikum Niederlausitz GmbH, Klinik für Unfallchirurgie und Orthopädie, Hand und Plastische Chirurgie, Standort Senftenberg, Germany

H. Richter

Klinikum Niederlausitz GmbH, Klinik für Unfallchirurgie und Orthopädie, Hand und Plastische Chirurgie, Standort Senftenberg, Germany

I.A. Dontas

Laboratory for Research of the Musculoskeletal System, KAT Hospital, Medical School, National and Kapodistrian University of Athens, Greece

I. K. Triantafyllopoulos

Laboratory for Research of the Musculoskeletal System, KAT Hospital, Medical School, National and Kapodistrian University of Athens, Greece

5th Orthopaedic Department, HYGEIA Private Hosptal, Athens,Greece

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Published
2022-09-28