Analysis of Patients 'Satisfactory Level after Total Knee Replacement Arthroplasty

PURPOSE: The object of this study was to evaluate the quality of life after total knee replacement arthroplasty concerning objective and subjective satisfaction. MATERIALS AND METHODS: This study included 46 cases in 30 patients who underwent total knee replacement arthroplasty during August 1998 and March 2003. The knee score and the function score were measured using the Clinical Rating System of the American Knee Society, and the degree of satisfaction before and after the operation was also evaluated by the Medical Outcomes Study Short Form-36(SF-36). RESULTS: After total knee replacement arthroplasty, an increase from 41.3 to 85.6 was seen using the Clinical Rating System, and the increase was 31 to 82 in the SF-36 evaluation method; the two methods showed relation in the satisfaction level. An average increase of 6% was seen in the activity level of patients after the operation, and 47% of the patients using hot-stone beds changed their beds to normal beds. CONCLUSION: The analysis using Clinical Rating System and SF-36 in patients who underwent total knee replacement arthroplasty was seen to efficiently express the patients 'subjective symptoms to objective data, and were more useful than other analysis methods in observing the patients 'prognosis.

Results of Total Knee Arthroplasty with NexGen(R) system (5-year follow up) / 대한정형외과학회잡지

PURPOSE: To evaluate the mid-term (over 5 years) clinical and radiologic results of NexGen(R) total knee replacement arthroplasty (TKRA)retrospectively. MATERIALS AND METHODS: Between Nov. 1996 and Jun. 1997, 57 knees in 43 patients who had been followed up for 5 years after TKRA with NexGen(R) were evaluated retrospectively for clinical and radiologic results. RESULTS: The average range of motion increased from 116degree preoperatively to 125 degrees at the last follow-up. In patients with osteoarthritis, the average preoperative knee score (59.9) and functional score (40.3) improved to 94.7 and 83.7, respectively. In rheumatoid arthritis patients, the mean knee score and functional score also improved from 55.6 and 35.9 to 88.9 and 79.9. Roentgenographic evaluation revealed a radiolucency rate of 60%. Complications were periprosthetic fractures in 2 cases and aseptic loosening in 1 case. The latter had received a reimplantation. CONCLUSION: The mid-term results of NexGen. TKRA were reliable and satisfactory in terms of improvements of; range of motion, restoration of function, and rare complications. However, long-term follow-up evaluation is necessary to monitor many cases of radiolucent line (60%) in the femoral component.

Total Knee Arthroplasty in Stiff Knee

PURPOSE: To evaluate the results of TKRA (Total knee replacement arthroplasty)for the treatment of stiff knee. METHODS & MATERIALS: TKRA has been performed for 18 cases of stiff knee ( ROM < 50 degrees ) between January 1994 and December 2000. 16 cases which have been followed up for more than 2 years were analysed. Average follow-up was 3.3 years(2-6 years). 3 were male and 13 were female. The average age was 55.8 years(34-75years). Sequales of infection were most with 6 cases and followed by osteoarthritis (4 cases, 2 cases had been performed arthroscopic debridement) and rheumatoid arthritis (3 cases) and traumatic arthritis (3 cases) in order. TKRA was performed on average 12.2 years (1-40 years) after knee stiffness has been developed. We evaluate the results with ROM, HSS score and complications. RESULTS: Average ROM was increased from 31.6 degrees(0 degrees-50 degrees) preoperatively to 95.4 degrees(80 degrees-120 degrees) postoperatively. 5 degrees of flexion contracture was present in only 1 case. Average HSS score was improved from 59.6 points preoperatively to 84.6 points postoperatively. The patella tendon was partially ruptured in 1 case during surgery, but by brace application and rehabilitative exercise, ROM was improved to 90 degrees, 1 year post operatively. There were 1 superficial skin infection which was resolved by revision of wound and skin graft, and deep infection in 3 cases, which needed knee fusion finally. CONCLUSION: TKRA is a good method for improving function in knee stiffness although infection risk is high.

Treatment of Infected TKRA / 대한정형외과학회잡지

PURPOSE: To investigate the causes and to determine the most useful test for the early diagnosis of infected TKRA, and to present the treatment modality and its possible complications. MATERIALS AND METHODS: We reviewed 17 cases, with follow up, among the 18 infected TKRA cases registered from March 1992 to June 2000. Diagnosis of deep infection after TKRA was made by assessing clinical symptoms, laboratory and radiological findings, nuclear scan studies and aspirate culture results. Data were analyzed clinically by HSS score, recurrence of infection and postoperative complications. RESULTS: The overall incidence of deep infection after TKRA was 1.4%. In fourteen of the 17 cases TKRA was revised. In 13 cases, excluding 1 case of infection recurrence after 2-stage TKRA revision, the mean ROM increased from 55o to 86o and the mean HSS score increased from 53 points to 84. Knee fusion was performed in 4 cases, including one case of infection recurrence after 2-stage TKRA revision. CONCLUSION: The most reliable clinical results were achieved after a 2-stage TKRA revision. Knee joint fusion should be considered when the general condition is poor, with an initial diagnosis of infection, and in the presence of skin problems.