Effect of femoral component flexion in total knee arthroplasty One-year follow-up results One-year follow-up results / 中国组织工程研究

ABSTRACT

BACKGROUND:The majority of people do not believe that the femoral component flexion in total knee arthroplasty affect or affect little postoperative function and it is the only that the radiographic films is not satisfactory.So it has not caused people's enollgh attention.But the femoral component flexion affects the results of total knee arthroplasty obviously.OnJECTIVETo investigate the curative effects of femoral component installed in the position of flexion during the operative procedure of total knee arthroplasty(123 knees)on the follow up results in 78 patients.DESIGN:Grouping contrast observation.SETTlNGFirst Department of Bone and Joint,Wangjing Hospital of China Academy of Traditional Cllinese Medicine.PARTlCIPANTS123 knees(78 patients)were given total knee arthroplasty in the First Department of Bone and Joint,Wangjing Hospital of China Academy of Traditional Chinese Medicine from October 2001 to June 2004.Seventeen(13.8%,15 patients)knees were found with femoral component flexion(FCF),in which there were 5 male cases and 10 female cases,aged from 47 to 81 years old.106(63 patients)knees were found without FCF,in which there were 22 male cases and 41 female cases,aged from 47 to 79 years old.METHODS:Total knee arthroplasties about their HSS rating scores,ranges of motion and flexion contractures werecompared in the two groups before operation and after operation,and the degrees of the FCF angle and the distances of femoral component flexion were measured.MAIN OUTCOME MEASURES:①Femoral Drostllesis flexion measurement;②HSS scores and activity③femoral prosthesis flexion angle and distance buckling;④adverse events and side effects.RESULTS:Follow up lasted for one year above.①The degrees of flexion of femoral components were from 7°to 19°(average 11.3°)and the distance of flexion was from 2 mm to 4 mm(average 2.6 mln)in those 17 knees of total knee arthroplasty.②Differences in HSS rating scores and range of motion were not statistically significant(P＞0.05)before operations between the group of femoral component flexion and the group of femoral component plane.However,after operations the above aspects in the group of femoral component flexion were less than that in the group of femoral component plane significantly(P=0.01,P＜0.01),and were statistically significant(P=0.02,P＜0.01)between post-operations and pre-operations in HSS rating scores and range of motion respectively in the two groups.③The statistic differences in cases and angles of flexion contractures of postperations between the group of femoral component flexion and the group of femoral component plane were significant(P＜0.01),the situation in the group of femornl component flexion were more bad than that in the group of femoral component plane,but were all improved significantly in cases and angles of flexion contractures after operations in the two groups(P＜0.05,P＜0.01).④There was one case with the right deep venous thrombosis and one case with myositis ossifican in non-FCF group,and there was one case in FCF group with impingement sign between patellar and component.CONCLUSION:The findings show that femoral component flexion will increase the incidence of knee flexion contracture and result in knee extension dysfunction after total knee arthroplasty surgery.