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General Orthopaedics

The Relationship Between Subjective And Objective Outcome Data After Total Knee Replacement

The South African Orthopaedic Association (SAOA) 57th Annual Congress



Abstract

Introduction:

Gait analysis is an important tool to measure function following total knee replacement. It is currently unknown whether there is a correlation between subjective and objective outcome. The purpose of this study was to analyse relationships between subjective outcome scores and kinematic and kinetic data.

Methods:

25 consecutive patients (15 males, 10 females) were selected (mean age 68 years, BMI 31.8). All subjects were tested a minimum of 24 months following total knee replacement. SF12, Oxford knee score, knee society and KOOS scores were collected. Muscle strength was assessed using a Biodex dynamometer and symmetry indices were analysed. A timed up and go test and KT2000 measurements were performed.

Results:

Strong correlations (r=0.52–0.74) were found between scoring systems (SF 12, Oxford knee score, knee society score, KOOS score) and the timed up and go test. Moderate correlations (r=0.27–0.35) were found between knee scores and KT2000 measurements. Only weak correlations (r=0.09–0.12) were found between knee scores and strength. None of the correlations reached statistical significance. Post hoc contrasts demonstrated adequate power (0.95) of the study.

Conclusion:

The finding of this study suggests that outcome scores and objective and functional tests following total knee arthroplasty measure different variables of outcome. Whilst objective tests and gait analysis provide an understanding of joint mechanics after surgery and can be used to calculate resultant forces and moments, patient perceived outcomes have no significant correlation to knee biomechanics. This may be related to factors such as pain relief, improved quality of life and the ability to perform activities of daily life. In contrast modern implants may provide a satisfactory outcome resulting in high patient satisfaction. The results of this study underline the importance of using subjective patient outcome measures.