PREDICTIVE VALUE OF PREOPERATIVE PERIARTICULAR MUSCLE QUALITY ON FUNCTIONAL AND CLINICAL OUTCOMES FOLLOWING PRIMARY TOTAL KNEE ARTHROPLASTY
Main Article Content
Keywords
Total knee arthroplasty, muscle quality, fatty infiltration, functional outcomes, computed tomography
Abstract
Periarticular muscle quality has emerged as a potential predictor of functional outcomes following total knee arthroplasty, yet limited data exist regarding its predictive value in Indian populations. This study evaluated the association between preoperative periarticular muscle quality parameters and postoperative functional and clinical outcomes in patients undergoing primary total knee arthroplasty for end-stage knee osteoarthritis.
Methods: This prospective observational cohort study was conducted at Dr. S N Medical College, Jodhpur, Rajasthan, from July 2023 to October 2023. A total of 142 patients aged 50 to 80 years with Kellgren-Lawrence grade 3 or 4 knee osteoarthritis underwent preoperative computed tomography imaging to assess muscle quality parameters including cross-sectional area, muscle attenuation values in Hounsfield units, and fatty infiltration ratio. Functional outcomes were measured using the Knee injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index, timed up-and-go test, six-minute walk test, and quadriceps strength assessments at baseline, 6 weeks, 3 months, 6 months, and 12 months postoperatively.
Results: Muscle quality parameters demonstrated stronger correlations with 12-month functional outcomes compared to muscle quantity measures. Vastus medialis muscle attenuation correlated significantly with KOOS quality of life scores (r = 0.612, p < 0.01), while fatty infiltration ratio showed strong negative correlation (r = -0.624, p < 0.01). Multiple regression analysis revealed that vastus medialis attenuation and fatty infiltration ratio independently predicted postoperative quality of life scores, accounting for 64.2 percent of variance after controlling for confounders.
Conclusion: Preoperative periarticular muscle quality parameters serve as significant predictors of functional outcomes following total knee arthroplasty. Routine preoperative muscle quality assessment could enhance risk stratification and guide personalized rehabilitation strategies.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Praveen Kumar Digwal
Resident, Department of Orthopedic, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.
Dr. Jeewan Choudhary
Senior Resident, Department of Orthopedics, S.K. Govt. Medical College, Sikar, Rajasthan, India.
Dr . Jiyalal Bairwa
Senior Resident, Department of Orthopedic, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.
