Chinese Journal of Tissue Engineering Research ›› 2016, Vol. 20 ›› Issue (4): 486-491.doi: 10.3969/j.issn.2095-4344.2016.04.006

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Total knee replacement for severe gouty knee arthritis

Liu Kang, Guo Guo-dong, Zhao Jian-ning   

  1. Department of Orthopedics, Clinical College, Nanjing University School of Medicine/Nanjing General Hospital of Nanjing Military Region of Chinese PLA, Nanjing 210002, Jiangsu Province, China
  • Received:2015-11-07 Online:2016-01-22 Published:2016-01-22
  • Contact: Zhao Jian-ning, Chief physician, Professor, Doctoral supervisor, Department of Orthopedics, Clinical College, Nanjing University School of Medicine/Nanjing General Hospital of Nanjing Military Region of Chinese PLA, Nanjing 210002, Jiangsu Province, China
  • About author:Liu Kang, Studying for master’s degree, Department of Orthopedics, Clinical College, Nanjing University School of Medicine/Nanjing General Hospital of Nanjing Military Region of Chinese PLA, Nanjing 210002, Jiangsu Province, China
  • Supported by:

    the Clinical Medical Science and Technology Foundation of Jiangsu Province, No. BL2012002; the Scientific Research Foundation of Nanjing City, No. 201402007

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Abstract:

BACKGROUND: The number of patients undergoing total knee replacement due to severe gouty arthritis is increasing rapidly in recent years, and the ages of patients also present younger and younger. However, its clinical efficacy remains controversial, and it is lack of retrospective systematic analysis.
OBJECTIVE: To assess the clinical efficacy of total knee replacement for severe gouty knee arthritis from several aspects, such as pain, function, quality of life and complications. 
METHODS: From January 2006 to January 2015, 17 patients (20 knees) with severe knee gouty arthritis received 
total knee replacement in Department of Orthopedics of Nanjing General Hospital of Nanjing Military Region of Chinese PLA. They underwent knee joint surface replacement with posterior cruciate ligament, and patella was not replaced. Posterior stabilized prosthesis was used. All patients were successfully followed up postoperatively. The Hospital for SpecialSurgery Knee Score, range of motion of the knee, Visual Analogue Scale score and SF-36 scale scores were determined before and after replacement and during final follow-up.
RESULTS AND CONCLUSION: Patients were followed up for 1-9 years. No serious complications occurred during and after replacement. The Hospital for Special Surgery Knee Score, range of motion of the knee, Visual Analogue Scale score and SF-36 scale scores were significantly higher after replacement and during final follow-up than those before replacement (P < 0.001). X-ray films showed good prosthesis position, satisfactory limb alignment without radiolucent lines or loosing. These findings verified that total knee replacement was considered as the final way to treat the severe gouty knee arthritis; its short-term clinical effect is significant, but systematic anti-uric acid, prevention and treatment of complications, pain control, function exercising, and healthy mood maintenance were needed to get a better long-term clinical efficacy.