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Patients Who Have Kellgren-Lawrence Grade 3 and 4 Osteoarthritis Benefit Equally From Total Knee Arthroplasty.

Publication ,  Journal Article
Goh, GS; Schwartz, AM; Friend, JK; Grace, TR; Wickes, CB; Bolognesi, MP; Austin, MS
Published in: J Arthroplasty
September 2023

BACKGROUND: Recently, some payers have limited access to total knee arthroplasty (TKA) to patients who have Kellgren-Lawrence (KL) grade 4 osteoarthritis only. This study compared the outcomes of patients who have KL grade 3 and 4 osteoarthritis after TKA to determine if this new policy is justified. METHODS: This was a secondary analysis of a series originally established to collect outcomes for a single, cemented implant design. A total of 152 patients underwent primary, unilateral TKA at two centers from 2014 to 2016. Only patients who had KL grade 3 (n = 69) or 4 (n = 83) osteoarthritis were included. There was no difference in age, sex, American Society of Anesthesiologists score, or preoperative Knee Society Score (KSS) between the groups. Patients who had KL grade 4 disease had a higher body mass index. KSS and Forgotten Joint Score (FJS) were collected preoperatively and at 6 weeks, 6 months, 1 year, and 2 years postoperatively. Generalized linear models were used to compare outcomes. RESULTS: Controlling for demographics, improvements in KSS were comparable between the groups at all time points. There was no difference in KSS, FJS, and the proportion that achieved the patient acceptable symptom state for FJS at 2 years. CONCLUSION: Patients who had KL grade 3 and 4 osteoarthritis experienced similar improvement at all time points up to 2 years after primary TKA. There is no justification for payers to deny access to surgical treatment for patients who have KL grade 3 osteoarthritis and have otherwise failed nonoperative treatment.

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Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

September 2023

Volume

38

Issue

9

Start / End Page

1714 / 1717

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Osteoarthritis, Knee
  • Orthopedics
  • Knee Joint
  • Humans
  • Body Mass Index
  • Arthroplasty, Replacement, Knee
  • 4003 Biomedical engineering
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Goh, G. S., Schwartz, A. M., Friend, J. K., Grace, T. R., Wickes, C. B., Bolognesi, M. P., & Austin, M. S. (2023). Patients Who Have Kellgren-Lawrence Grade 3 and 4 Osteoarthritis Benefit Equally From Total Knee Arthroplasty. J Arthroplasty, 38(9), 1714–1717. https://doi.org/10.1016/j.arth.2023.03.068
Goh, Graham S., Andrew M. Schwartz, Jennifer K. Friend, Trevor R. Grace, C Baylor Wickes, Michael P. Bolognesi, and Matthew S. Austin. “Patients Who Have Kellgren-Lawrence Grade 3 and 4 Osteoarthritis Benefit Equally From Total Knee Arthroplasty.J Arthroplasty 38, no. 9 (September 2023): 1714–17. https://doi.org/10.1016/j.arth.2023.03.068.
Goh GS, Schwartz AM, Friend JK, Grace TR, Wickes CB, Bolognesi MP, et al. Patients Who Have Kellgren-Lawrence Grade 3 and 4 Osteoarthritis Benefit Equally From Total Knee Arthroplasty. J Arthroplasty. 2023 Sep;38(9):1714–7.
Goh, Graham S., et al. “Patients Who Have Kellgren-Lawrence Grade 3 and 4 Osteoarthritis Benefit Equally From Total Knee Arthroplasty.J Arthroplasty, vol. 38, no. 9, Sept. 2023, pp. 1714–17. Pubmed, doi:10.1016/j.arth.2023.03.068.
Goh GS, Schwartz AM, Friend JK, Grace TR, Wickes CB, Bolognesi MP, Austin MS. Patients Who Have Kellgren-Lawrence Grade 3 and 4 Osteoarthritis Benefit Equally From Total Knee Arthroplasty. J Arthroplasty. 2023 Sep;38(9):1714–1717.
Journal cover image

Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

September 2023

Volume

38

Issue

9

Start / End Page

1714 / 1717

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Osteoarthritis, Knee
  • Orthopedics
  • Knee Joint
  • Humans
  • Body Mass Index
  • Arthroplasty, Replacement, Knee
  • 4003 Biomedical engineering
  • 3202 Clinical sciences
  • 1103 Clinical Sciences