Incidence of Internal Derangement of Knee in the case of Total Knee Arthroplasty

ABSTRACT

PURPOSE: To evaluate the incidence and types of internal derangement of the knee, observed during total knee arthroplasty in patients with degenerative osteoarthritis and to correlate the findings with preoperative clinical presentations. MATERIALS AND METHODS: From January 1996 to January 2002, 435 patients(622 cases) with degenerative osteoarthritis who underwent total knee arthroplasty were analyzed for the presence of meniscal or cruciate ligament injuries. The type, site and patterns of injuries of the meniscus were recorded. Then the patients were categorized into group I; without meniscal injuries and group II; with meniscal injuries. Comparative analyses were also made between the two groups according to age, height, body weight, hospital for special surgery score(HSS score), the knee society clinical rating system(TKSCRS) score, and injuries of ACL and PCL. RESULTS: The medial meniscal injury is the most frequently involved type and was found in 288 cases(46.3%). Midportion to posterior horn location and midportion radial and posterior horn complex patterns showed the most cases in respect to site and pattern of meniscal injury. ACL injury was found in 48 cases while 55 cases showed PCL injury. Preoperative range of motion(I 128.5 +/-9.7 degree, II 114.8 +/-15.5 degree) and knee functional tests, such as, HSS score(I 61.9 +/-14.0, II 56.8 +/-14.9) and TKSCRS score(I 97.3 +/-27.3, II 81.1 +/-31.1) were significantly low in group II(p<0.05). Average age was 64.3 years in group I and 67.8 years in group II respectively. And age ranges were higher in group II(p<0.05). Injury of ACL and PCL were more common in group II. CONCLUSION: Meniscus injuries that were frequently seen in total knee arthroplasty have clinical relations to the patient 's ages, range of motion, function.