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[Surgical technique and clinical results of total knee arthroplasty in treating endstage gonarthrosis combined with valgus knee deformity].
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 May; 26(5):513-7.ZX

Abstract

OBJECTIVE

To investigate the surgical technique and the clinical results of total knee arthroplasty (TKA) in treating end-stage gonarthrosis combined with valgus knee deformity.

METHODS

Between November 1998 and October 2010, 64 patients (72 knees) with end-stage gonarthrosis combined with valgus knee deformity underwent TKA by a medial parapatellar approach. Of the 64 patients, 18 were male and 46 were female with an average age of 62.5 years (range, 23-82 years), including 44 cases (49 knees) of osteoarthritis, 17 cases (20 knees) of rheumatoid arthritis, 2 cases (2 knees) of haemophilic arthritis, and 1 case (1 knee) of post-traumatic arthritis. Bilateral knees were involved in 8 cases, and single knee in 56 cases. The flexion and extension range of motion (ROM) of the knee joint was (82.2 +/- 28.7) degrees; the femur-tibia angle (FTA) was (18.0 +/- 5.8) degrees; according to Knee Society Score (KSS) criterion, the preoperative clinical score was 31.2 +/- 10.1 and functional score was 37.3 +/- 9.0. According to Krackow's classification, there were 65 knees of type I and 7 knees of type II. By medial parapatellar approach, conventional osteotomy and Ranawat soft tissue release were performed in all cases. Prosthesis of preserved posterior cruciate ligament were used in 7 cases (7 knees), posterior stabilize prosthesis in 54 cases (60 knees), constrained prosthesis in 4 cases (5 knees).

RESULTS

Incisions healed by first intention in all cases. Peroneal nerve palsy occurred in 1 patient with haemophilic arthritis, severe valgus deformity (FTA was 41 degrees), and flexion contracture (20 degrees), which was cured after 1 year of conservative treatment. Revison surgery was performed in 1 case of deep infection at 2 years after surgery. All the patients were followed up 4.9 years on average (range, 1-13 years). At last follow-up, the FTA was (7.0 +/- 2.5) degrees, showing significant difference when compared with preoperative value (t = 15.502, P = 0.000). The KSS clinical score was 83.0 +/- 6.6 and functional score was 85.1 +/- 10.5, the flexion and extension ROM of the knee joint was (106.1 +/- 17.0) degrees, all showing significant differences when compared with preoperative values (P < 0.05). Five patients had 12-15 degrees valgus knee deformity, but the function of the affect knees were good.

CONCLUSION

TKA is an effective way for the patients with end-stage gonarthrosis combined with valgus knee deformity by medial parapatellar approach combined with conventional osteotomy and Ranawat soft tissue release. The correction of deformity and improvement of joint function can be achieved significantly. The clinical result is satisfactory.

Authors+Show Affiliations

Wang X
Department of Orthopaedics, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, PR China.
Weng X
No affiliation info available
Lin J
No affiliation info available
Jin J
No affiliation info available
Qian W
No affiliation info available

MeSH

AdultAgedAged, 80 and overArthritis, RheumatoidArthroplasty, Replacement, KneeFemaleHumansJoint Deformities, AcquiredKnee JointKnee ProsthesisLigaments, ArticularMaleMiddle AgedOsteoarthritis, KneeOsteotomyPatellaRange of Motion, ArticularRetrospective StudiesTreatment OutcomeYoung Adult

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

22702039

Citation

Wang, Xingshan, et al. "[Surgical Technique and Clinical Results of Total Knee Arthroplasty in Treating Endstage Gonarthrosis Combined With Valgus Knee Deformity]." Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi = Zhongguo Xiufu Chongjian Waike Zazhi = Chinese Journal of Reparative and Reconstructive Surgery, vol. 26, no. 5, 2012, pp. 513-7.
Wang X, Weng X, Lin J, et al. [Surgical technique and clinical results of total knee arthroplasty in treating endstage gonarthrosis combined with valgus knee deformity]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012;26(5):513-7.
Wang, X., Weng, X., Lin, J., Jin, J., & Qian, W. (2012). [Surgical technique and clinical results of total knee arthroplasty in treating endstage gonarthrosis combined with valgus knee deformity]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi = Zhongguo Xiufu Chongjian Waike Zazhi = Chinese Journal of Reparative and Reconstructive Surgery, 26(5), 513-7.
Wang X, et al. [Surgical Technique and Clinical Results of Total Knee Arthroplasty in Treating Endstage Gonarthrosis Combined With Valgus Knee Deformity]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012;26(5):513-7. PubMed PMID: 22702039.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Surgical technique and clinical results of total knee arthroplasty in treating endstage gonarthrosis combined with valgus knee deformity]. AU - Wang,Xingshan, AU - Weng,Xisheng, AU - Lin,Jin, AU - Jin,Jin, AU - Qian,Wenwei, PY - 2012/6/19/entrez PY - 2012/6/19/pubmed PY - 2013/2/16/medline SP - 513 EP - 7 JF - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery JO - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi VL - 26 IS - 5 N2 - OBJECTIVE: To investigate the surgical technique and the clinical results of total knee arthroplasty (TKA) in treating end-stage gonarthrosis combined with valgus knee deformity. METHODS: Between November 1998 and October 2010, 64 patients (72 knees) with end-stage gonarthrosis combined with valgus knee deformity underwent TKA by a medial parapatellar approach. Of the 64 patients, 18 were male and 46 were female with an average age of 62.5 years (range, 23-82 years), including 44 cases (49 knees) of osteoarthritis, 17 cases (20 knees) of rheumatoid arthritis, 2 cases (2 knees) of haemophilic arthritis, and 1 case (1 knee) of post-traumatic arthritis. Bilateral knees were involved in 8 cases, and single knee in 56 cases. The flexion and extension range of motion (ROM) of the knee joint was (82.2 +/- 28.7) degrees; the femur-tibia angle (FTA) was (18.0 +/- 5.8) degrees; according to Knee Society Score (KSS) criterion, the preoperative clinical score was 31.2 +/- 10.1 and functional score was 37.3 +/- 9.0. According to Krackow's classification, there were 65 knees of type I and 7 knees of type II. By medial parapatellar approach, conventional osteotomy and Ranawat soft tissue release were performed in all cases. Prosthesis of preserved posterior cruciate ligament were used in 7 cases (7 knees), posterior stabilize prosthesis in 54 cases (60 knees), constrained prosthesis in 4 cases (5 knees). RESULTS: Incisions healed by first intention in all cases. Peroneal nerve palsy occurred in 1 patient with haemophilic arthritis, severe valgus deformity (FTA was 41 degrees), and flexion contracture (20 degrees), which was cured after 1 year of conservative treatment. Revison surgery was performed in 1 case of deep infection at 2 years after surgery. All the patients were followed up 4.9 years on average (range, 1-13 years). At last follow-up, the FTA was (7.0 +/- 2.5) degrees, showing significant difference when compared with preoperative value (t = 15.502, P = 0.000). The KSS clinical score was 83.0 +/- 6.6 and functional score was 85.1 +/- 10.5, the flexion and extension ROM of the knee joint was (106.1 +/- 17.0) degrees, all showing significant differences when compared with preoperative values (P < 0.05). Five patients had 12-15 degrees valgus knee deformity, but the function of the affect knees were good. CONCLUSION: TKA is an effective way for the patients with end-stage gonarthrosis combined with valgus knee deformity by medial parapatellar approach combined with conventional osteotomy and Ranawat soft tissue release. The correction of deformity and improvement of joint function can be achieved significantly. The clinical result is satisfactory. SN - 1002-1892 UR - https://www.unboundmedicine.com/medline/citation/22702039/[Surgical_technique_and_clinical_results_of_total_knee_arthroplasty_in_treating_endstage_gonarthrosis_combined_with_valgus_knee_deformity]_ DB - PRIME DP - Unbound Medicine ER -