TY - JOUR
T1 - An Intact Anterior Cruciate Ligament at the Time of Posterior Cruciate Ligament–Retaining Total Knee Arthroplasty Was Associated With Reduced Patient Satisfaction and Inferior Pain and Stair Function
AU - Jacobs, Cale A.
AU - Christensen, Christian P.
AU - Karthikeyan, Tharun
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background Patients with an intact anterior cruciate ligament (ACL) at the time of ACL-sacrificing total knee arthroplasty (TKA) have been suggested to have inferior outcomes compared with those with a dysfunctional ACL. However, to date, no published clinical studies have evaluated the potential link between the condition of the ACL at the time of posterior cruciate ligament–retaining TKA and postoperative pain, function, and satisfaction. As such, the purpose of this study was to compare subjective function, movement-elicited pain, pain at rest, and patient satisfaction between those with an intact or dysfunctional ACL. Methods We identified 562 posterior cruciate ligament–retaining TKAs with complete intraoperative and postoperative data. Patients were categorized based on the condition of the ACL at the time of TKA as either being intact or dysfunctional (absent or lax). Knee Society Function Scores, movement-elicited pain, pain at rest, and patient satisfaction were then compared between groups. Results At mean follow-up of 5.1 years, a significantly lower proportion of patients in the intact group were satisfied with their operation (intact: 391/453 [86.3%] vs dysfunctional: 102/109 [93.6%], P =.0496). Inspection of the individual activities revealed that the groups did not differ in walking ability or pain when walking; however, the intact group reported significantly reduced ability to navigate stairs with greater pain during that activity. Conclusion The lack of difference in pain at rest between groups suggests that pain and functional impairments during more demanding activities such as navigating stairs may be associated with the lost function of the ACL rather than by altered central pain processing.
AB - Background Patients with an intact anterior cruciate ligament (ACL) at the time of ACL-sacrificing total knee arthroplasty (TKA) have been suggested to have inferior outcomes compared with those with a dysfunctional ACL. However, to date, no published clinical studies have evaluated the potential link between the condition of the ACL at the time of posterior cruciate ligament–retaining TKA and postoperative pain, function, and satisfaction. As such, the purpose of this study was to compare subjective function, movement-elicited pain, pain at rest, and patient satisfaction between those with an intact or dysfunctional ACL. Methods We identified 562 posterior cruciate ligament–retaining TKAs with complete intraoperative and postoperative data. Patients were categorized based on the condition of the ACL at the time of TKA as either being intact or dysfunctional (absent or lax). Knee Society Function Scores, movement-elicited pain, pain at rest, and patient satisfaction were then compared between groups. Results At mean follow-up of 5.1 years, a significantly lower proportion of patients in the intact group were satisfied with their operation (intact: 391/453 [86.3%] vs dysfunctional: 102/109 [93.6%], P =.0496). Inspection of the individual activities revealed that the groups did not differ in walking ability or pain when walking; however, the intact group reported significantly reduced ability to navigate stairs with greater pain during that activity. Conclusion The lack of difference in pain at rest between groups suggests that pain and functional impairments during more demanding activities such as navigating stairs may be associated with the lost function of the ACL rather than by altered central pain processing.
KW - anterior cruciate ligament
KW - function
KW - pain
KW - patient satisfaction
KW - total knee arthroplasty
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U2 - 10.1016/j.arth.2016.01.026
DO - 10.1016/j.arth.2016.01.026
M3 - Article
C2 - 26860965
AN - SCOPUS:85000842789
SN - 0883-5403
VL - 31
SP - 1732
EP - 1735
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 8
ER -