|
|
|
| Effect of Knee Valgus Correction on Prognosis of Total Knee Arthroplasty |
| WU Di, LI Jia, LUO Jinwei, et al |
| The Affiliated Hospital of Chengde Medical University, Hebei Chengde 067000,China |
|
|
|
|
Abstract Objective: To investigate the effect of knee valgus correction on the prognosis of total knee arthroplasty (TKA). Methods: A total of 102 patients with knee osteoarthritis (KOA) complicated with knee valgus deformity in our hospital from January 2018 to January 2021 were included. They were treated with TKA. Hip knee ankle angle (HKA) was measured one week after operation. According to HKA angle ≤3° and >3°, 78 cases and 24 cases were set as normal group and residual valgus group, respectively. The knee scoring system of American Hospital of special surgery (HSS), osteoarthritis score of Western Ontario and McMaster University (WOMAC) and knee range of motion (ROM) were compared between the two groups before and one year after operation. The femoral angle, tibial angle and patellar inclination angle were measured one year after operation. Results: The WOMAC score after operation was significantly lower than that before operation, and the HSS score and knee ROM increased significantly (P<0.05). There was no significant difference in WOMAC score, HSS score and knee ROM (P>0.05). The femoral angle, tibial angle, patellar inclination angle and HKA angle decreased significantly in the two groups (P<0.05), and the four indexes in the normal group were lower than those in the residual valgus group (P<0.05). Conclusion: The residual valgus after KOA combined with knee valgus after TKA has no significant impact on the recent knee function and pain. It can be considered that there is no need to completely correct the knee valgus. Although the recovery of lower limb force line after operation is less than that of normal knee valgus, whether it affects the long-term curative effect needs to be further evaluated.
|
|
|
|
|
|
[1] van Hamersveld K T,Marang-van de Mheen P J,Nelissen R.The effect of coronal alignment on tibial component migration following total knee arthroplasty:a cohort study with long-term radiostereometric analysis results[J].Bone Joint Surg Am,2019,101(13):1203-1212.
[2] 李超,季明亮,王善正,等.全膝关节置换术治疗膝外翻的矫正程度对临床疗效的影响[J].中华外科杂志,2021,59(12):1019-1021.
[3] 国家老年疾病临床医学研究中心(湘雅医院),中华医学会骨科学分会关节外科学组.中国髌股关节骨关节炎诊疗指南(2020年版)[J].中华骨科杂志,2020,40(18):1227-1234.
[4] Macchiarola L,Grassi A,Di Paolo S,et al.The Italian cross-cultural adaptations of the paediatric International knee documentation committee score and the hospital for special surgery paediatric functional activity brief scale are reliable instruments in paediatric population[J].Knee Surg Sports Traumatol Arthrosc.2020,28(8):2657-2662.
[5] 王媛媛,王亮,王云玲,等.3.0T磁共振T2×mapping成像技术定量评估膝关节骨性关节炎的临床价值及与WOMAC评分的相关性分析[J].现代生物医学进展,2021,21(17):3256-3259,3309.
[6] 万大地,段祥瑞,袁野,等.重度外翻膝畸形全膝关节置换术治疗进展[J].中国医药导刊,2020,22(11):776-780.
[7] 彭俊洋,魏俊成,颜世昌,等.内侧与外侧髌旁入路TKA治疗膝关节骨性关节炎并膝外翻畸形的疗效分析[J].中国骨与关节损伤杂志,2018,33(12):1291-1293.
[8] 王强,周强.运动力学对线截骨对全膝关节置换术后运动学、生物力学及膝关节功能的影响[J].中华骨与关节外科杂志,2021,14(11):916-922.
[9] 马德思,王志为,温亮,等.运动学及机械对线全膝关节置换术早期临床结果对比[J].中华关节外科杂志:电子版,2021,15(2):163-170.
[10] 唐杞衡,周一新,宋洋,等.膝关节置换术后翻修的主要原因分析[J].骨科临床与研究杂志,2019,4(1):15-17,21.
[11] 赵春涛,卿明松,余浪波,等.运动学对线和机械力学对线指导全膝关节置换效果的Meta分析[J].中国组织工程研究,2020,24(9):1435-1442.
[12] Bae D K,Baek J H,Yoon K T,et al.Comparison of patellofemoral outcomes after TKA using two prostheses with different patellofemoral design features[J].Knee Surg Sports Traumatol Arthrosc,2017,25(12):3747-3754.
[13] Lee WC,Kwan YH,Chong HC,et al.The minimal clinically important difference for knee society clinical rating system after total knee arthroplasty for primary osteoarthritis[J].Knee Surg Sports Traumatol Arthrosc,2017,25(11):3354-3359. |
|
|
|
2022, Vol. 28 
