A comprehensive comparative study on mid-term clinical and functional outcomes in Indian patients following bilateral total knee arthroplasty: assessing the impact of body mass index on post-total knee arthroplasty results

Background: Limited research exists on Indian obese patients undergoing simultaneous bilateral total knee arthroplasty (bTKA), necessitating a comprehensive and comparative analysis with non-obese counterparts. This study presents an observational and prospective assessment of Indian patients who underwent cruciate retaining/posterior stabilized (CR/PS) metal-backed implant surgeries from 2016 to 2019. Methods: The study encompassed 190 patients (380 knees) undergoing bTKA, classified by World Health Organization (WHO) weight stratification: normal weight (cohort 1, n=51), overweight (cohort 2, n=85), and obese (cohort 3, n=54). Primary endpoints were implant survivorship and revision rates, with secondary endpoints including range of motion (ROM), knee society score (KSS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC), and SF-36 scores. Results: Female representation dominated all groups (88.24%, 87.06%, and 90.74%). End-stage osteoarthritis occurred in 94.12%, 96.47%, and 98.15%, respectively. Over the 3-year follow-up, four fatalities occurred, with 186 patients completing the study. ROM showed significant improvement after three years, with baseline values increasing from 93.29°±18.29° (cohort 1) to 123.97°±2.28°, 122.86°±5.03°, and 122.67°±4.77°, respectively (p<0.001). KSS demonstrated substantial improvement (cohort 1: 89.87±6.48, cohort 2: 90.47±8.40, cohort 3: 90.52±8.07) after three years. A 100% success rate and no revisions indicated implant durability. WOMAC and SF-36 questionnaires exhibited significant improvements in pain, stiffness, and overall well-being (p<0.001) after bTKA. Conclusions: This mid-term CR/PS knee survival analysis underscores 100% implant functionality, improved knee function, and enhanced quality of life for all patients, irrespective of their body mass index (BMI). Simultaneous bilateral TKA with CR/PS implants demonstrates favourable outcomes, affirming its efficacy as a viable treatment option

Age wise comparative analysis of patients undergoing total knee arthroplasty: a multicenter indigenous experience

Background: This study assesses the mid-term clinical and functional outcomes, implant survivorship and impact of age on patients implanted with either cruciate retaining/posterior stabilized (CR/PS) total knee system (TKS). Method: This is an ongoing, prospective, multicentre, real-world study enrolling 300 patients: younger adults (<55 years; n=69), older adults (55 years to <65 years; n=92) and elders (≥65 years; n=139). Primary safety endpoints: implant survivorship and cumulative revision rate. Secondary endpoints: Knee Society Score (KSS), Western Ontario and McMaster universities osteoarthritis (WOMAC) score, range of motion (ROM), SF-36 questionnaire for assessment of quality of life (QoL), radiographic analysis, and any adverse events at 6 weeks, 6 months, 1-3 years.  Results: Primary endpoint demonstrated absence of any revision across all age categories during the 3 years study period. Secondary outcomes KSS (clinical and functional) showed non-significant difference among elderly (91.13±7.90 and 98.18±4.62, respectively) in comparison to young adults (91.03±8.61 and 98.91±3.75, respectively). All three age-groups showed significant improvement in ROM (p<0.001) till 3 years 121.05°±7.74°, 123.22°±4.26°, and 122.43°±5.8° respectively, with no differences among the age groups. We observed that WOMAC and SF-36 QoL scores improved with each follow-up (p<0.001) across all age groups. Radiographs showed no implant wear or osteolysis during the investigation. Conclusions: Age seems to play no notable role on the post-TKA outcomes. Over a 3-year period, we observed marked enhancements in patient measures such as ROM, KSS, WOMAC, and QoL indicating and strongly affirming the safety and efficacy of CR/PS TKS prostheses.