Abstract
Introduction
There has not been a comparison of patients and outcomes between two separate countries for any knee prosthesis. This study compares total knee replacement outcomes between an Indonesian and American cohort. We aim to compare the clinical results between two different hospitals in two different countries using post-operative range of motion as the primary clinical result.
Materials and Methods
177 Indonesian RPF TKR patients were compared to 84 American patients. Demographics, patient recorded outcomes scores (KSS, PAQ, WOMAC), flexion, and component size were compared between the groups. Standard t-test was used to compare the variables between the two countries and regression analysis adjusting for age, BMI, length of follow-up, sex, preoperative WOMAC and PAQ score, preoperative KSS knee score, preoperative KSS function score, and preoperative UCLA was used to compare outcomes.
Results
Between the Indonesian and American RPF cohorts there was significant difference between age (64.6±7.08 vs. 67.8±6.53; p=.003), preoperative KSS function score (54.2±14.1 vs. 60.4±18.4; p=.011), preoperative WOMAC (71.2±7.9 vs. 65.1±16.9; p=.012), postoperative KSS Knee score (93.3±4.74 vs. 95.7±6.25; p=.003), and postoperative KSS function score (97.0±4.26 vs. 93.5±13.1). No difference was found in pre or postoperative flexion. Regression analysis found no significance difference in outcomes between Indonesian and American patients when adjusted for variables (p=0.45).
Conclusions
Despite cultural differences, the Indonesian and American cohort had similar clinical outcomes including improved flexion, which coincides with a high flexion knee design. Interestingly, Indonesian patients rated themselves worse on patient recorded preoperative outcome scores. More research is needed to investigate the difference between the cultural impacts on TKR outcomes.
