Evidence map›Paper›PMID 36864440›Full record

ArticleJournal of orthopaedic surgery and research2023

Spondylolisthesis and mismatch deformity affect outcomes after total knee arthroplasty.

William L Sheppard, Daniel Chiou, Alexander Upfill-Brown, Akash Shah, Eghosa Edogun, Adam Sassoon, Don Y Park

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

William L SheppardDepartment of Orthopedic Surgery, University of California, Los Angeles, 1250 16th St Suite 2100, Santa Monica, CA, 90404, USA.
Daniel ChiouDepartment of Orthopedic Surgery, University of California, Los Angeles, 1250 16th St Suite 2100, Santa Monica, CA, 90404, USA.
Alexander Upfill-BrownDepartment of Orthopedic Surgery, University of California, Los Angeles, 1250 16th St Suite 2100, Santa Monica, CA, 90404, USA.
Akash ShahDepartment of Orthopedic Surgery, University of California, Los Angeles, 1250 16th St Suite 2100, Santa Monica, CA, 90404, USA.
Eghosa EdogunDavid Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA.
Adam SassoonDepartment of Orthopedic Surgery, University of California, Los Angeles, 1250 16th St Suite 2100, Santa Monica, CA, 90404, USA.
Don Y ParkDepartment of Orthopedic Surgery, University of California, Los Angeles, 1250 16th St Suite 2100, Santa Monica, CA, 90404, USA. dypark@mednet.ucla.edu.
University of California, Los Angeles · US

Funding

Regenerative Musculoskeletal Medicine Training ProgramT32AR059033 · NIAMS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI John S Adams, Nicholas M. Bernthal · 2011 to 2026
$4.8M
NIAMS NIH HHS T32 AR059033
6 · The paper itself

Abstract

backgroundLittle published data currently exist regarding the potential relationships between spondylolisthesis, mismatch deformity, and clinical outcomes following total knee arthroplasty (TKA). We hypothesize that preexisting spondylolisthesis will result in decreased functional outcomes after TKA.

methodsThis retrospective cohort comparison of 933 TKAs was performed between January 2017 and 2020. TKAs were excluded if they were not performed for primary osteoarthritis (OA) or if preoperative lumbar radiographs were unavailable/inadequate to measure the degree of spondylolisthesis. Ninety-five TKAs were subsequently available for inclusion and divided into two groups: those with spondylolisthesis and those without. Within the spondylolisthesis cohort, pelvic incidence (PI) and lumbar lordosis (LL) were calculated on lateral radiographs to determine the difference (PI-LL). Radiographs with PI-LL > 10° were then categorized as having mismatch deformity (MD). The following clinical outcomes were compared between the groups: need for manipulation under anesthesia (MUA), total postoperative arc of motion (AOM) both pre-MUA or post-MUA/revision, incidence of flexion contracture, and a need for later revision.

resultsForty-nine TKAs met the spondylolisthesis criteria, while 44 did not have spondylolisthesis. There were no significant differences in gender, body mass index, preoperative knee range of motion (ROM), preoperative AOM, or opiate use between the groups. TKAs with spondylolisthesis and concomitant MD were more likely to have MUA (p = 0.016), ROM < 0-120 (p < 0.014), and a decreased AOM (p < 0.02) without interventions.

conclusionPreexisting spondylolisthesis by itself may not have adverse effect clinical results following TKA. However, spondylolisthesis increases the likelihood of developing MD. In those with both spondylolisthesis and concomitant mismatch deformities, patients had statistically and clinically significantly decreased in postoperative ROM/AOM and increased need for MUA. Surgeons should consider clinical/radiographic assessments of patients with chronic back pain who present for total joint arthroplasty. LEVEL OF EVIDENCE: Level 3.

Indexed as

Arthroplasty, Replacement, KneeSpondylolisthesisAnimalsBody Mass IndexHumansKnee JointRetrospective StudiesDegenerative spondylolisthesisMismatchOutcomesTotal knee arthroplasty

Identifiers

PMID36864440
PMCPMC9979472
OpenAlexW4322770765

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.