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Despite 'knee abuse,' Asian knees present comparable outcomes to Western knees in TKA

The knees in Korean patients yielded survival rates similar to those of Western patients, despite lifestyle differences.

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SEOUL — Many Asian patients place a high burden on their knees due to the constant bending and wide range of motion involved in daily activities. Yet, this added stress does not significantly impact the life of most knee implants, according to a Korean orthopedic surgeon.

Tae-Ho Kim, MD, and colleagues at Asan Medical Center, Kangbuk Samsung Medical Center and Hanil General Hospital reported on a prospective, multicenter study of 432 cases in 278 knees that underwent total knee arthroplasty (TKA) with the NexGen CR and NextGen Legacy knee implants [both from Zimmer] between June 1998 and April 2002. The average follow-up period was 6.3 years (range, 4 to 8 years). About 40 cases were lost to follow-up (90.8% completion).

The cumulative survival at 8 years was 98.4% among the Korean patients, with an endpoint of revision for any reason, and 99.2% with an endpoint of revision for aseptic failure.

"We observed significant improvement in patients' knee scores range of motion over the [8-year] follow-up period," he said. The investigators reported six cases of radiographic periprosthetic osteolysis; three cases required revision under aseptic loosening of tibial components.

Kim said that these mid-term findings are comparable to most of the research he has seen on Western knees.

"There is a lot of 'knee abuse' placed on Asian knees - including bending for praying and frequent deep flexions in everyday life — but the results were similar to those seen in Western patients," he said.

He added that these findings should shed some light on an important topic in the TKA literature.

"Most of the research in the medical literature about implant survival and clinical outcomes of total knee arthroplasty involve Western patients. It is very hard to find similar research on Asian knees, but hopefully this will give us new [insight]," Kim said.

For more information:

• Bin S-L, Kim T-H, Kim J-M, Lee S-H. A prospective survivorship analysis of total knee arthroplasty in the Koreans. F036-2. Presented at the 15th Triennial Congress of the Asia Pacific Orthopaeidc Association. Sept. 9-13, 2007. Seoul.