Analysis of the special clinical features of 1202 cases of total knee arthroplasty / 中华骨科杂志

ABSTRACT

Objective A retrospective analysis was conducted on 1 202 cases of total knee replacements (TKR) during the periord of 14 years, in order to study the special clinical features of the patients and their knee deformities, with the final purpose of finding the appropriate methods for the management. Methods From April 1987 to Augest 2001, 1202 cases of total knee arthroplasty were performed for 833 patients. There were 464 unilateral TKRs in 464 patients, and 738 bilateral TKRs in 369 patients. The diagnosis of the clincal conditions were osteoarthritis (include synovial chondromatosis and kaschin beck disease), rheumatoid arthritis, ankylosing spondylitis, also included were some rare rheumatic diseases of the knee such as pigmented villonodular synovitis, tuberculous arthritis, Charcot arthritis, hemophilic arthritis and psoriatic arthritis. Patients in this series also had several kinds of severe deformities such as genu varus with dislocation or medial plateau defect, genu valgus, flexion contracture of the knee, flexion deformity with joint fusion, flexion joint fusion with subluxation, and deformity in the low extremities involving multiple joints in patients with JRA. Results Some severe deformities were considered as contraindication of surfacing total knee replacement, however the life quality of patients had significant improvement after operations. Through the improvement of surgical skill, the complications following TKR in severe knee flexion deformity are less in number than that happened in the early days. Conclusion 1) TKR in China at the moment is facing more challenges and difficulties than that in the developed countries. 2)The proper types of prosthesis should be selected beforehand in order to get the good result. 3) Physical therapy is very important in the rehabilitation following TKR, so that the establishment of full time rehabilitation team is mandatory. 4)The key point for promoting TKR treatment for patients with various knee disease is to develop homemade prosthesis in China. [