| Objective: To investigate correction methods of varus deformity when applying knee replacement for kneevarus osteoarthritis patients and application advantages of surface-typerotating platform knee prosthesis in the treatment and postoperative short-termclinical effect observation.Methods: From October 2009~ June 2011, Bone and Joint Branch of Affiliated Hospital of Shandong Universityof Traditional Chinese Medicine applied Link Gemini MKⅡrotating meniscus artificial kneeprosthesis in treating 52 patients (60 knees) with varus knee osteoarthritissurface inflammation by knee replacement surgery. In the operation based on different types and constituting factors of varus knee, moderate soft tissueloosening and correspondingly precise strands cut were conducted to recoverstatic knee osteoarthritis line, meanwhile accurate prosthesis was placed. Allthe Patients had the replacement of artificially total knee for the first time,without replacement of patellar. The patients include 15 males and 37 females, aged from 45 to 79 years old, with the average being 62. Clinicalevaluation of Arthroplasty has been made by referring to the scoring systems on knee joints and on Feller patella of American Hospital for Special Surgery(HSS), so that differences on the following items would be clearly defined: HSSscores on knee joints, Patellofemoral function scores, anterior knee painscores, improvement of Range of Motion, Patella scores, and X-ray of the femoral tibial angles before and after the Arthroplasty, one month and half ayear after the Arthroplasty respectively. As a result, curative effects indifferent stages after TKA can be confirmed. Observations should be made onposition of the prosthesis, radiation through the light around femoral andtibial components in order to find signs of prosthesis loosening. Paired t teststatistical method needs to be applied to compare scores before the Arthroplasty with the final follow-up scores, P<0.01 is the difference thatis statistically significant.Result: The 52patients (60 knees) were followed up for a certain time varying from 6 monthsto 23 months, averagely 16 months. Surgical incision shealed without infection and significant intra-articular hematoma. 1,Efficacy: pain relief and knee function of patients has significantly improved. Imaging shows there is no loosening, subluxation or dislocation signs. 2,Patients were followed up for the HSS score, patellar function scores, anterior knee painscore, knee range of motion, patellar score which has increased significantly .HSS score increased from(37.8±13.4)to(88.4±5.2)at the last follow-up.Thepatellofemoral function score has increased from (6.1±1.7) to(11.2±2.7). The scores of range of the knee improved from (10.5±2.4) to (12.8±1.2). Patella score increased from(15.8±3.3)to(25.3±3.2)for the last follow-up. Femorotibial angle FTA was corrected from (188.3±3.1) to (174.2±1.5). Theresults showed that one month after operation,the HSSscore, patellar function scores, anterior knee pain scores, knee range score,the patella and FTA were very much improved and the Paired t test is P <0.01. The difference was statistically significant. It is confirmed that rotating platform knee prosthesis in the treatment of varus osteoarthritisis satisfactory in the recent clinical tests.Conclusion: Artificial knee joint of rotating platform surface-type could provide adequatejoint contacting area, and polyethylene liner with certain degree of free rotating can effectively reduce postoperative pain as well as the polyethylenewear between knee prosthesis. In the meantime the type and component factors of genu varum should be determined before the operation. The operation takes anorientational action to moderately release the soft tissue and correct the osteotomy. And total knee replacement could ensure malformation of genu varumget good correction and restore the biomechanical characteristics of normal knee joints.
|
PDF Full Text Request