On relationship between intraoperative findings during joint replacement and clinical manifestations in elderly patients with knee osteoarthritis / 中国微创外科杂志

ABSTRACT

Objective To study the relationship between intraoperative findings during knee joint replacement and clinical manifestations in elderly patients with knee osteoarthritis.Methods A total of 150 cases of senile knee osteoarthritis(182 knee joints) was selected for total knee replacement.Their X-ray examination results were gathered for recording the impairment of the articular surface,the joint space narrowing,and the location and amount of osteophytes.An MRI examination was performed in some of the cases for recording changes of fibrocartilage and locations of meniscus.Results Out of the 150 cases,there were 108 cases of genu varum(mean inversion angle,12.5?;range,0?~25?),21 cases of genu valgum(mean eversion angle,18.3?;range,15?~25?),and 21 cases of flexion contracture (mean angle,15.3?;range,0?~40?).The X-ray findings showed varying degrees of joint space narrowing in all the 150 cases,and osteophytes on the posterior border or at lateral part of the knee joint in 131 cases(152 joints).MRI examinations were performed in 11 cases(15 joints),in which discontinuous,cystoid,and worn-out fibrocartilages were seen.Radial displacement of the meniscus was found.Intraoperative findings proved that the fibrocartilage on the articular surface on the side with joint space narrowing was severely worn away,the collateral ligaments were contracted,the osteophytes were seen at the posterior part of the tibia and the femur,and abrasion or radial displacement of the meniscus on the side with joint space narrowing.Conclusions Joint space narrowing,varus or valgus deformity,osteophytes,and radial displacement of the meniscus are usually found in aged patients with knee osteoarthritis.