title: The predictors of outcome in total knee arthroplasty for post-traumatic arthritis.
abstract: BACKGROUND
  The outcomes of total knee arthroplasty (TKA) for post-traumatic arthritis are less reliable than for idiopathic osteoarthritis. These patients tend to be younger, present with varying degrees of deformity, and often have a history of prior surgery, resulting in a wide spectrum of pathology. We hypothesized that preoperative variables, in particular the location of deformity, would predict pain and functional outcomes.
  
  
  METHODS
  The outcomes of total knee arthroplasty for post-traumatic arthrosis were studied in 47 knees treated at our institution. All patients were administered the Knee Society Score (KSS) preoperatively and at follow-up (mean 52months, range 16 to 124). We classified the defects into four categories: intra-articular, metaphyseal, diaphyseal, and combined femoral and tibial deformities.
  
  
  RESULTS
  There was a significant improvement in KSS scores for pain (p<0.0001) and a trend toward higher function (p=0.06) comparing preoperative scores to final follow-up. The largest improvements in pain and functional scores were in patients with isolated articular deformities, while patients with combined tibial and femoral deformities did not have significant improvements in pain or function. Soft-tissue defects requiring flap coverage were associated with worsening in the pain score (p=0.027).
  
  
  CONCLUSIONS
  The location of post-traumatic deformity and compromise of the soft-tissue envelope influence the pain and functional outcomes of total knee arthroplasty for post-traumatic arthritis. Specifically, isolated articular deformities have the largest improvement in pain and function while patients with combined tibial and femoral deformities as well as patients with soft-tissue compromise experience poor outcomes.
  
  
  METHODS
  IV-Retrospective Case Series.
authors: University of California, San Francisco Medical Center, San Francisco, CA, USA. Electronic address: ShearerD@orthosurg.ucsf.edu.
authors: David W
authors: DW
authors: Shearer
authors: Vince
authors: V
authors: Chow
authors: Kevin J
authors: KJ
authors: Bozic
authors: Joseph
authors: J
authors: Liu
authors: Michael D
authors: MD
authors: Ries
mesh_terms: D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods* / Q000534:rehabilitation; D015331:Cohort Studies; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods; D006801:Humans; D016916:Joint Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007718:Knee Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
keywords: Clinical outcomes; Post-traumatic arthritis; Total knee arthroplasty