ABSTRACT
Objective To observe the early clinical efficacy of PFC fixed platform and RP rotating platform prosthesis two kinds of artificial knee replacement system for the treatment of knee osteoarthritis.Methods 39 cases (39 knees)with knee osteoarthritis were treated with total knee arthroplasty(TKA).According to intraoperative use of different types of prosthesis,the cases were divided into two groups:fixed platforms group 16 cases and rotating platform group 23 cases.The wound healing,patients with gait and knee activity after operation were observed.Results Three cases took place postoperative deep vein thrombosis,after conservative treatment,the symptoms improved and discharged,two cases of postoperative wound fat liquefaction,by dressing wound healing,time stitches discharged.3 to 12 months follow-up visit(average 10 months),all patients could walk uptight without noticeable limp.Last follow-up group,fixed platforms,rotating platform group Knee Score (HSS) and knee activity (ROM) were (83.17 ± 7.12),(81.32 ± 5.39) points and (109.73 ± 6.35) °,(103.12 ± 4.28) °,compared with the preoperative differencewasstatisticallysignificant (AgroupHSS:t =22.10,ROM:t =9.21 ; BgroupHSS:t =30.69,ROM:t =9.54,all P ＜ 0.01),but the difference between groups was not statistically significant(HSS:t =0.88,ROM:t =3.63,all P ＞ 0.05).Conclusion Using PFC and RP prosthesis after total knee replacement system in early has a good effect,both of which improve joint function early with no significant difference,but long-term effects need further observation.
ABSTRACT
Objective To explore the clinical results of total knee arthroplasty (TKA) in the treatment of knees with bony ankylosis in extension.Methods From June 2000 to June 2007,10 patients had knees with bony ankylosis in extension were treated with TKA,including 4 males and 6 females,with an average age of 49 years (range,29 to 63 years).The primary diseases were as follows:ankylosing spondylitis in 3 cases,rheumatoid arthritis in 2 cases,hemophilic arthritis in 1 care,traumatic arthritis in 3 cases and pyogenic arthritis in 1 case.The range of motion (ROM) was 0° in all knees,and the average HSS (the Hospital for Special Surgery) score before operation was 32.5±10.26.Two patients underwent bilateral TKA,and 8 underwent unilateral TKA.Results All patients were followed up for 3 to 10 years (average,5.3 years).The average HSS score was improved to 87.75±6.45 at the last follow-up,and there was significant difference compared with that before operation (t=18.668,P=0.000).The average ROM was improved to 97.08°±11.57°at the last follow-up,and there was remarkable difference compared with that before operation (t=29.063,P=0.000).The postoperative complications included cutaneous necrosis in 2 cases,deep venous thrombosis of lower limb in 1 case,periprosthetic fracture in 1 case,and deep prosthetic infection in 1 case who underwent revised TKA later.The postopertative X-ray showed no looseness of the prostheses.Conclusion TKA through medial parapatellar approach,with dissection of the rectus femoris,secondary osteotomy and soft tissue balance intraoperatively is effective in the treatment of knees with bony ankylosis in extension,which can correct the ankylosed knee deformitis successfully.Combining with the correct rehabilitation exercise,it is possible to improve significantly the function of knee and life quality in these patients.