The significance of an asymmetric extension gap on routine radiographs after total knee replacement: A new sign and its clinical significance
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The significance of an asymmetric extension gap on routine radiographs after total knee replacement: A new sign and its clinical significance. / Liebs, T R; Kloos, S-A; Herzberg, W; Ruether, Wolfgang; Hassenpflug, J.
in: BONE JOINT J, Jahrgang 95-B, Nr. 4, 01.04.2013, S. 472-7.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - The significance of an asymmetric extension gap on routine radiographs after total knee replacement: A new sign and its clinical significance
AU - Liebs, T R
AU - Kloos, S-A
AU - Herzberg, W
AU - Ruether, Wolfgang
AU - Hassenpflug, J
PY - 2013/4/1
Y1 - 2013/4/1
N2 - We investigated whether an asymmetric extension gap seen on routine post-operative radiographs after primary total knee replacement (TKR) is associated with pain at three, six, 12 and 24 months' follow-up. On radiographs of 277 patients after primary TKR we measured the distance between the tibial tray and the femoral condyle on both the medial and lateral sides. A difference was defined as an asymmetric extension gap. We considered three groups (no asymmetric gap, medial-opening and lateral-opening gap) and calculated the associations with the Western Ontario and McMaster Universities osteoarthritis index pain scores over time. Those with an asymmetric extension gap of ≥ 1.5 mm had a significant association with pain scores at three months' follow-up; patients with a medial-opening extension gap reported more pain and patients with a lateral-opening extension gap reported less pain (p = 0.036). This effect was still significant at six months (p = 0.044), but had lost significance by 12 months (p = 0.924). When adjusting for multiple cofounders the improvement in pain was more pronounced in patients with a lateral-opening extension gap than in those with a medial-opening extension gap at three (p = 0.037) and six months' (p = 0.027) follow-up.
AB - We investigated whether an asymmetric extension gap seen on routine post-operative radiographs after primary total knee replacement (TKR) is associated with pain at three, six, 12 and 24 months' follow-up. On radiographs of 277 patients after primary TKR we measured the distance between the tibial tray and the femoral condyle on both the medial and lateral sides. A difference was defined as an asymmetric extension gap. We considered three groups (no asymmetric gap, medial-opening and lateral-opening gap) and calculated the associations with the Western Ontario and McMaster Universities osteoarthritis index pain scores over time. Those with an asymmetric extension gap of ≥ 1.5 mm had a significant association with pain scores at three months' follow-up; patients with a medial-opening extension gap reported more pain and patients with a lateral-opening extension gap reported less pain (p = 0.036). This effect was still significant at six months (p = 0.044), but had lost significance by 12 months (p = 0.924). When adjusting for multiple cofounders the improvement in pain was more pronounced in patients with a lateral-opening extension gap than in those with a medial-opening extension gap at three (p = 0.037) and six months' (p = 0.027) follow-up.
KW - Arthroplasty, Replacement, Knee
KW - Cohort Studies
KW - Follow-Up Studies
KW - Humans
KW - Knee Joint
KW - Pain
KW - Pain Measurement
KW - Postoperative Complications
KW - Time Factors
U2 - 10.1302/0301-620X.95B4.31080
DO - 10.1302/0301-620X.95B4.31080
M3 - SCORING: Journal article
C2 - 23539698
VL - 95-B
SP - 472
EP - 477
JO - BONE JOINT J
JF - BONE JOINT J
SN - 2049-4394
IS - 4
ER -