Short-term functional and radiological outcomes following primary total knee replacement surgery at mulago national referral hospital and corsu hospital.

Abstract

Background: Total Knee Replacement (TKR) is a widely accepted procedure for end-stage knee osteoarthritis that reduces pain and improves physical function in these patients. Most patients have generally good outcomes however, 20% may experience unsatisfactory outcomes. The variation in outcomes is attributed to several factors including age, BMI, physiotherapy etc. In recent years there has been an increase in TKR surgeries in Uganda, however no studies have assessed functional outcomes among the patients post-TKR. This study aimed to determine the short-term functional outcomes of TKR and factors associated among patients who had undergone TKR in MNRH and CoRSU hospital.Main objective: To evaluate the short-term functional and radiological outcomes following Total Knee Replacement surgery at MNRH and CoRSU hospital.Methods: This was a cross-sectional study conducted at MNRH and CoRSU hospital. 68 participants post-TKR were consecutively recruited to evaluate short-term functional and radiological outcomes, using the Knee Society Score (KSS) and the Knee Society Roentgenographic Evaluation and Scoring System (KSRES) respectively. Demographic data was collected through a structured questionnaire and analyzed using SPSS version 16 to explore relationships between dependent and independent variables.Results: The study assessed 68 participants (70.4% from MNRH and 29.6% from CORSU) with a median age of 65 years, evaluating 78 knees post-TKR at a median follow-up of 13.9 months. Most participants (73.5%) had comorbidities. The median clinical and functional knee scores of 87 and 80 respectively, showing a significant difference (p=0.003). Increased pain correlated with reduced walking and stair-climbing ability (p<0.001). Radiologically, 62.8% of knees had normal femur coronal alignment (2-7° valgus), 79% had neutral tibiofemoral angles, however 24% achieved neutral (90°) tibial component coronal alignment, which was significantly associated with better functional scores (p=0.003). Normal femoral flexion and tibial slope were observed in 50% and 97% of knees, respectively, and minimal radiolucency (9%, none >2mm). Bilateral TKR patients had significantly worse clinical and functional scores compared to unilateral cases (p<0.05), underscoring the impact of surgical extent on outcomes.Conclusion: Primary TKR at both MNRH and CoRSU hospitals yields favorable short-term functional and radiological outcomes, consistent with global studies. However, optimal outcomes may be influenced by patient-specific factors such as the number of knees operated, comorbidities, physiotherapy, and employment status. These findings emphasize the need for individualized post-op care and further longitudinal studies to assess long-term outcomes.