Total knee arthroplasty for terminal knee disease: short-term follow-up

doi:10.3969/j.issn.2095-4344.2015.26.007

Abstract

Abstract:

BACKGROUND: In recent decades, total knee arthroplasty is widely used in the treatment of terminal knee joint diseases, such as osteoarthritis, rheumatoid arthritis, traumatic arthritis and other bone diseases. The methods of osteotomy, soft tissue balance and prosthesis rotation positioning have always been debated and discussed in total knee arthroplasty.
OBJECTIVE: To explore the repair effect of total knee arthroplasty for terminal knee disease.
METHODS: Total knee arthroplasty was performed for treating terminal knee disease in 31 cases (31 knees), including 26 cases of osteoarthritis (26 knees) and 5 cases of rheumatoid arthritis (5 knees). All cases accompanied flexion contracture deformity to different degrees. The maximum angle of flexion deformity was < 25°. All patients were scored by hospital for special surgery knee score before and after replacement. All 31 knees were treated with fixed platform posterior-stabilized prostheses.
RESULTS AND CONCLUSION: No complications, such as early infection and prosthesis dislocation, were found after surgery. Joint pain apparently lessened, flexion and varus deformity obviously improved after replacement. Postoperative X-ray films showed good prosthesis position and low limb alignment. All cases were followed up for 6-12 months. The hospital for special surgery knee score improved significantly from preoperatively 46.4±5.3 to postoperatively 84.6±10.5 after 6 months of follow-up. Excellent and good rate was 84%. Results indicate that total knee arthroplasty for treating terminal knee disease has a good clinical effect. However, the operation is complex and precise technique is required.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Knee, Osteoarthritis, Arthritis, Rheumatoid, Follow-up Studies

CLC Number:

R318

Lu B, Wang JH, Zhang J, Li SW, Hu WY, Chen XQ. Total knee arthroplasty for terminal knee disease: short-term follow-up[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(26): 4132-4138.

Figures/Tables 3

References

[1] Li S, Chen Y, Su W. Systematic review of patellar resurfacing in total knee arthroplasty. Int Orthop. 2011; 35(3):305-316.
[2] Radcliff KE, Orozco FR, Quinones D. Preoperative risk stratification reduces the incidence of perioperative complications after total knee arthroplasty. J Arthroplasty. 2012;27(8 Suppl):77-80.
[3] Lee DS，Song EK, Seon JK, et al. Effect of balanced gap total knee arthroplasty on intraoperative laxities and femoral component rotation. J Arthroplasty. 2011;26(5): 699-704.
[4] Chen W, Nagamine R, Kondo K,et al. Effect of medial soft-tissue releases during posterior-stabilised total knee arthroplasty. J Orthop Surg (Hong Kong). 2011;19(2): 230-233.
[5] Berger RA, Rubash HE, Seel MJ, et al. Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis.Clin Orthop. 1993; 286:40-47.
[6] Schnurr C, Nessler J. Is referencing the posterior condyles sufficient to achieve a rectangular flexion gap in total knee arthroplasty. Int Orthop. 2009;6:1561-1565．
[7] Fujii T, Kondo M, Tomari K. Posterior condylar cartilage may distort rotational alignment of the femoral component based on posteriorcondylar axis in total knee arthroplasty. Surg Radiol Anat. 2012;34(7):633-638.
[8] Harman MK, Banks SA, Kirschner S, et al. Prosthesis alignment affects axial rotation motion after total knee replacement: a prospective in vivo study combining computed tomography and fluoroscopic evaluations. BMC Musculoskelet Disord. 2012;13:206.
[9] Lützner J, Kirschner S, Günther KP. Patients with no functional improvement after total knee arthroplasty show different kinematics. Int Orthop. 2012;36(9):1841-1847.
[10] Pietsch M, Hofmann S. Early revision for isolated internal malrotation of the femoral component in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2012; 20(6):1057-1063.
[11] Rienmüller A, Guggi T, Gruber G. The effect of femoral component rotation on the five-year outcome of cemented mobile bearing total knee arthroplasty Int Orthop. 2012; 36(10):2067-2072.
[12] Tao K, Cai M, Zhu Y. Aligning the tibial component with medial border of the tibial tubercle-is it always right? Knee. 2014 ; 21(1):295-298
[13] Bell SW, Young P, Drury C .Component rotational alignment in unexplained painful primary total knee arthroplasty. Knee. 2014;21(1):272-277.
[14] Tsukeoka T, Tsuneizumi Y, Lee TH. The effect of the posterior slope of the tibial plateau osteotomy with a rotational error on tibial component malalignment in total knee replacement. Bone Joint J. 2013;95-B(9):1201-1203.
[15] Tsukeoka T, Tsuneizumi Y, Lee TH. The effect of rotational fixation error of the tibial cutting guide and the distance between the guide and the bone on the tibial osteotomy in total knee arthroplasty. J Arthroplasty. 2013;28(7):1094-1098.
[16] Mihalko WM, Williams JL. Total knee arthroplasty kinematics may be assessed using computer modeling: a feasibility study .Orthopedics. 2012;35(10 Suppl):40-44.
[17] Hoffart HE, Langenstein E, Vasak N. A prospective study comparing the functional outcome of computer-assisted and conventional total knee replacement. J Bone Joint Surg Br. 2012;94(2):194-199.
[18] 孙振辉.刘军.田峥巍. 间隙平衡技术在全膝关节置换术中应用的中期随访研究[J].中国矫形外科杂志,2013, 21(13): 1292-1295.
[19] 李守民,徐玮,孔荣.全膝关节置换术中不同截骨顺序的比较[J]. 临床骨科杂志,2012,15 (4):382-383.
[20] 吕尚军，李文强.膝关节置换治疗膝内翻畸形的力学分析[J].中国组织工程研究与临床康复,2009,13(9):1715-1718.
[21] 冯华杰,吴焯鹏,匡光志.高龄老人膝关节骨关节炎行全膝关节表面置换术的疗效观察[J].中华关节外科杂志(电子版),2014,8(3): 19-21.
[22] 刘鹏飞,郭林,田丰德.人工全膝关节置换术治疗单侧膝内翻合并屈曲挛缩畸形的临床分析[J].中国骨与关节损伤杂志,2013, 28(2):119-121.
[23] Hunt NC, Ghosh KM, Athwal KK, et al. Lack of evidence to support present medial release methods in total arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2014;22(12): 3100- 3112. [24] 王兴山,翁习生,林进.人工全膝关节置换术治疗终末期膝关节病变合并膝外翻畸形的手术技巧及临床疗效评价[J].中国修复重建外科杂志,2012,26(5):513-517.
[25] Girard J, Amzallag M, Pasquier G. Total knee arthroplasty in valgus knees: predictive preoperative parameters influencing a constrained design selection. Orthop Traumatol Surg Res. 2009;95(4):260-266.
[26] Lachiewicz PF, Soileau ES. Results of a second-generation constrained condylar prosthesis in primary total knee arthroplasty. J Arthroplasty. 2011;26(8):1228-1231.
[27] Jain A, Stein BE, Skolasky RL.Total joint arthroplasty in patients with rheumatoid arthritis: a United States experience from 1992 through 2005. J Arthroplasty. 2012;27(6):881-888.
[28] 孙铁铮,吕厚山.晚期类风湿关节炎合并膝关节强直或僵直畸形行人工膝关节置换术[J].中华关节外科杂志:电子版,2011,5(1): 3-9.
[29] 徐小会,王华溢,段永宏.人工全膝关节置换术治疗膝关节类风湿性关节炎中短期疗效随访[J].中华关节外科杂志(电子版),2014, 8(3):31-35.
[30] Tanzer M, Miller J. The natural history of flexion contracture in total knee arthroplasty. A prospective study. Clin Orthop Relat Res. 1989;(248):129-134.
[31] Trieb K, Schmid M .Long-term outcome of total knee replacement in patients with rheumatoid arthritis. Joint Bone Spine. 2008;75(2):163-166.
[32] Rand JA, Ilstrup DM. Survivorship analysis of total knee arthroplasty. Cumulative rates of survival of 9200 total knee arthroplasties. J Bone Joint Surg Am. 1991;73(3):397-409.
[33] Aglietti P, Buzzi R, Insall-Burstein posterior-stabilized knee prosthesis in rheumatoid arthritis. J Arthroplasty. 1995;10(2): 217-225.
[34] 李金龙,李为,樊大钊,等.后方稳定型全膝人工关节置换术30例分析[J].中国矫形外科杂志,2007,15(21):1656-1658.
[35] 王维军,牛东生.重症类风湿性关节炎膝关节屈曲挛缩畸形全膝关节置换术的软组织平衡[J].中国修复重建外科杂志, 2008, 22(10):1173-1176.
[36] 卜延民,于建华,赵秀祥,等.采用保留后交叉韧带旋转半月板假体人工全膝关节置换治疗类风湿关节炎的临床研究[J].中国修复重建外科杂志,2010,24(6):696-700.
[37] Walter F, Haynes MB, Markel DC. A randomized prospective study evaluating the effect of patellar eversion on the early functional outcomes in primary total knee arthroplasty. J Arthroplasty. 2007;22(4):509-514.
[38] Dalury DF, Mulliken BD, Adams MJ. Early recovery after total knee arthroplasty performed with and without patellar eversion and tibial translation. A prospective randomized study. J Bone Joint Surg Am. 2009;91(6):1339-1343.
[39] Arnout N, Victor J, Cleppe H. Avoidance of patellar eversion improves range of motion after total knee replacement: a prospective randomized study. Knee Surg Sports Traumatol Arthrosc. 2009;17(10):1206-1210.
[40] Umrani SP, Cho KY, Kim KI. Patellar eversion does not adversely affect quadriceps recovery following total knee arthroplasty. J Arthroplasty. 2013;28(4):591-594.
[41] Eid MJ, Booth G, Khan RJ. Patellar eversion during total knee replacement: a prospective, randomized trial. J Bone Joint Surg Am. 2014;96(3):207-213.