Functional Outcomes of Difficult Primary Total Knee Arthroplasty Assessed by the Bristol Knee Score at Six Months: A Tertiary Care Center Experience

Objective: This study aimed to evaluate the functional outcomes of difficult primary knee arthroplasty performed at a tertiary care center using the Bristol Knee Score. Methodology: This study included patients attending the outpatient department (OPD) at Government Medical College, Thiruvananthapuram, who had undergone difficult primary total knee arthroplasty (TKA) six months prior. Informed consent was obtained from all participants. A minimum of 42 eligible patients were included in the study. After obtaining consent, a detailed clinical history and physical examination were conducted. Postoperative assessment included evaluation of follow-up anteroposterior (AP) and lateral radiographs of the knee. Functional outcomes were assessed using the Bristol Knee Score. Results: The study demonstrated significant improvement in functional outcomes following surgery. Preoperatively, all patients had poor knee scores, with a mean Bristol Knee Score of 44.3±2.1. At six months postoperatively, the mean score improved significantly to 85.6±5.6. Among the participants, 17 (40.5%) patients achieved a good knee score, while 25 (59.5%) patients achieved an excellent knee score. These findings highlight the effectiveness of TKA in improving knee function and overall quality of life in patients with severe knee pathology. Conclusion: No significant correlation was observed between functional outcomes and variables such as age, sex, socioeconomic status, comorbidities, body mass index (BMI), duration of surgery, or length of hospital stay. These findings suggest that TKA provides favorable outcomes across diverse patient groups.