Effect of prosthesis selection on flexion-extension function after total knee arthroplasty

Shuangli ZHOU; Jintang WANG; Jun LI

ABSTRACT

BACKGROUND:

With the development of new materials and the improvement of prosthesis design, total knee arthroplasty(TKA), a commonly used surgery, has exhibited satisfying effect on the treatment of rheumatoid arthritis and osteoarthrosis. However, many problems still remain a headache to operation performers.

OBJECTIVE:

To discuss how to select the prosthesis for total knee replacement and to summarize the key factors that affect the curative effect.

DESIGN:

A controlled study of the effect before and after the operation.

SETTING:

Department of Orthopedics, First Hospital of Xi'an Jiaotong University.

PARTICIPANTS:

Thirty-six patients(24 males and 12 females) who received TKA in the Department of Orthopaedics, First Hospital of Xi'an Jiaotong University during February 2000 to September 2003 were included in this study.

METHODS:

A retrospective study was carried out. Thirty-six patients(48knees) underwent total knee replacement, and the knee joint function was evaluated with American John N Install scoring system. The post-operation effect was evaluated by comparing the scores of each diseased knee before and after the operation.MAIN OUTCOME

MEASURES:

The function of knees and the score of every knee before and after operation were evaluated.

RESULTS:

The mean score before operation was 39, but it was 85 after follow-up visit. Totally 95% of them were up to the standard. The pain was reduced after the operation. The flexion-extension function and mobility of the knee joints improved obviously.

CONCLUSION:

TKA with posterior stabilized prosthesis and resection of posterior cruciate ligament(PCL) improved the function of the diseased knees after the operation. And the operation was simple and without complications. The key factors that affect the curative effect include the mechanical balance of the soft tissues during the operation, perioperative anticoagulant treatment for the prevention of deep vein thrombosis(DVT) and postoperative rehabilitation training. Peripheral tissue of knee joints should be released adequately; otherwise, it may cause unstable joint or limitation of joint activity.