Artroplastia total de rodilla con diseño de pivote medial: rol del dolor basal en la mejoría clínica y funcional a un año

• Autores: Fallaque-Ruiz, Yordhanno X., Centeno-Leguia, Dercy, Mendoza-Vera, Valeria N., Avendaño-Uchuya, Oswald, Fallaque-Ruiz, Carlos E., Cajo-Salvador, Jose
• Formato: artículo
• Fecha de Publicación: 2026
• Institución: Universidad de San Martín de Porres
• Repositorio: Horizonte médico
• Lenguaje: español
• OAI Identifier: oai:horizontemedico.usmp.edu.pe:article/4442
• Enlace del recurso: https://horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/4442
• Nivel de acceso: acceso abierto
• Materia: Artroplastia; Dolor; Medición de Resultados Informados por el Paciente; Osteoartritis de la Rodilla; Arthroplasty; Pain; Patient Reported Outcome Measures; Osteoarthritis, Knee

Objective: To evaluate clinical and functional outcomes following primary medial pivot total knee arthroplasty (MP-TKA) and to analyze factors associated with pain improvement at one year. Materials and methods: A prospective single-center cohort study including patients with Kellgren–Lawrence grade 3–4 knee osteoarthritis who underwent primary MP-TKA. Outcomes were assessed preoperatively and at 3, 6, and 12 months using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Short Form-36 (SF-36). The primary outcome was change in KOOS Pain (ΔKOOS Pain) at one year. A parsimonious multivariable linear regression model was used. Results: Twenty-five patients were included (mean age: 67.8 ± 7.9 years; 64% women). KOOS Pain improved from 44.4 ± 8.9 to 79.0 ± 13.7 at one year. ΔKOOS Pain was 34.6 points (95% CI: 26.8–42.3; p <0.001), exceeding the minimum clinically important difference. Improvements were observed across all KOOS and SF-36 domains. Preoperative KOOS Pain was the only factor independently associated with pain improvement (β=−1.46; 95% CI: −2.15 to −0.77; p < 0.001). Conclusions: MP-TKA was associated with significant clinical and functional improvement at one year. Baseline pain was a key determinant of postoperative improvement, with implications for patient selection and expectation management.