Total knee arthroplasty for osteoarthritis of the knee with extra-articular deformity / 中华骨科杂志

ABSTRACT

Objective To evaluate the feasibility and clinical results of one-stage total knee arthroplasty in patients with extra-articular deformity and osteoarthritis of the knee. Methods From June 2006 to April 2010, 9 patients with osteoarthritis of the knee and extra-articular deformity underwent one-stage total knee arthroplasty, including 2 males and 7 females with an average age of 51 years (range, 34-69). These deformities were in the tibia in 4 patients and in the femur in 5. The deformity resulted from fracture malunion in 8 cases and dysplasia in one. There were 6 uniplanar and 3 biplanar deformities. The average angle of the femoral deformities was 13.3° in the coronal plane (ranged from 8° to 22°) and 11.3° in the sagittal plane (ranged from 6° to 15°). One femur had a 10° deformity of external rotation. The average angle of the tibial deformities was 16° in the coronal (ranged from 11° to 22°), One was 21° in the sagittal plane. Results The mean follow-up period was 29 months (range, 7-54) after surgery. The average HSS score improved from 18.7 points preoperatively to 89.8 points at the time of the last follow-up. The average arc of knee motion improved from 46.7° preoperatively to 100.6° postoperatively. The average deviation of mechanical axis of knee was improved from 11.8° of excursion preoperatively to 1° of excursion at the time of the last follow-up. One patient had an unsatisfactory clinical result from delayed union at the esteotomy site. No complications such as infection, DVT, ligament instability, patella problem or component loosening. Conclusion One-stage total knee arthroplasty is a technically difiicult but effective treatment for patients with osteoarthritis of the knee and extra-articular deformity. We recommend that if feasible total knee arthroplasty with intra-articular bone resection and soft-tissue balancing for these patients.