ABSTRACT
INTRODUCTION: Knee osteoarthritis and low back pain (LBP) are two conditions with relatively high prevalence in patients over 65 years. The objective was to determine the effect of symptomatic LBP on the patient-reported outcome after primary TKA. MATERIAL AND METHOD: A cohort of 48 patients with concomitant LBP was prospectively matched 1:2 with patients without LBP for gender, age, body mass index and preoperative knee function. LBP severity was measured with the Oswestry Disability Index (ODI). Patient-reported outcomes were assessed with reduced Short-Form (SF12), Western Ontario and McMaster Universities score (WOMAC), and visual analogue scale (VAS) for satisfaction. Functional outcome was assessed with the Knee Society Scores (KSS). RESULTS: The mean postoperative follow-up was 3.2 years. At last follow-up, LBP cohort had significantly worse SF12, WOMAC, KSS and VAS scores than those patients without LBP. Preoperative ODI score was significantly correlated with outcomes. CONCLUSION: Worse functional and patient-reported outcomes were obtained in patients over 65 years with concomitant LBP, and this was related to the intensity of preoperative LBP. Despite successful outcome in the knee, the LBP usually remains after TKA and this may impair satisfaction and patient-reported outcomes. These patients should be properly informed about their potential outcomes.
Subject(s)
Arthroplasty, Replacement, Knee/adverse effects , Knee Joint/surgery , Low Back Pain/epidemiology , Osteoarthritis, Knee/surgery , Pain, Postoperative/epidemiology , Aged , Female , Follow-Up Studies , Humans , Knee Joint/diagnostic imaging , Low Back Pain/diagnosis , Male , Pain Measurement , Pain, Postoperative/diagnosis , Prospective Studies , Spain/epidemiology , Time FactorsABSTRACT
A 58 year old man is described who developed a subcutaneous synovial cyst over the acromioclavicular joint. The cyst developed in association with a massive tear of the rotator cuff and the long head of the biceps, which was demonstrated by arthrography. A loose fragment of the acromion was found intraoperatively. The patient was treated surgically by a combination of excision of the cyst, acromioplasty, removal of the loose acromial fragment, and a duramater allograft to close the rotator cuff defect. The functional result was unsatisfactory.
