Movable platform unicompartmental knee arthpoplasty for spontaneous osteonecrosis of knee: a five-year follow-up

doi:10.3969/j.issn.2095-4344.2891

Abstract

Abstract:

BACKGROUND: Spontaneous osteonecrosis of knee joint mainly affects the medial condyle of femur and is a good indication for unicompartmental knee arthpoplasty. However, the therapeutic effect after unicompartmental knee arthpoplasty is still controversial.

OBJECTIVE: To explore the clinical effect of movable platform unicompartmental knee arthpoplasty for knee spontaneous osteonecrosis in 5-year follow-up.

METHODS: From January 2014 to January 2015, the data of patients diagnosed as spontaneous osteonecrosis of medial compartment of knee joint and treated with unicompartmental knee arthpoplasty of mobile platform in the Department of Arthrology of Foshan Hospital of Traditional Chinese Medicine were analyzed retrospectively. Totally 64 patients were included according to the inclusion and exclusion criteria. The data of age, sex, body weight, necrotic site, Koshino stage and necrotic volume were collected and analyzed. Knee maximum range of motion, American Special surgery Hospital score, Oxford knee joint score and visual analogue scale pain score were used to evaluate knee function before and during follow-up. Preoperative and follow-up evaluations of the lower extremity line of force were performed through full-length X-ray films of both lower extremities, and the presence of complications was observed.

RESULTS AND CONCLUSION: (1) Sixty-two patients affected femoral metatarsal necrosis; two patients had medial tibial plateau necrosis; 40 patients had Koshino stage III; 24 cases had stage IV; lesion volume was 5.62 to 32.52 cm³; 45 cases had small-area necrosis; and 14 cases had middle area necrosis. There were five cases of large-area necrosis. (2) All the patients were healed by stage I. The follow-up period was 60-72 months. One patient had dislocation of the polyethylene liner 3 months after surgery and was used again for surgery. The function was good after thickening the pads. Two patients showed loosening of the prosthesis 4 years after the operation, and were revised to total knee replacement. The remaining patients had no infection, dislocation of the prosthesis, loosening of the prosthesis, venous thrombosis of the lower limbs, pulmonary embolism, and cardiovascular and cerebrovascular accidents, or post-traumatic psychiatric disorders during the follow-up. (3) American Special surgery Hospital score, Oxford knee joint score, knee joint maximum range of motion, and visual analogue scale pain score were significantly improved at the last follow-up than before surgery, and the difference was statistically significant (P < 0.05). (4) At the last follow-up, hip-knee-ankle angle and tibiofemoral angle were significantly improved than before surgery (P < 0.05). The lower limb force line was corrected. (5) It is concluded that the treatment of spontaneous osteonecrosis of knee with movable platform unicompartmental knee arthpoplasty has the advantages of less trauma, more bone mass retention, quick recovery, obvious improvement of lower limb force line, good joint function after operation, and satisfactory mid-term effect.

Key words: bone, knee, osteonecrosis, joint, unicompartmental knee arthpoplasty, mobile platform, prosthesis, follow up

CLC Number:

Niu Guoqing, Peng Zhihao, Wen Jianqiang, Pan Yaocheng, Lu Guoliang. Movable platform unicompartmental knee arthpoplasty for spontaneous osteonecrosis of knee: a five-year follow-up[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(33): 5283-5288.

Figures/Tables 5

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