| Background:Total Knee Arthroplasty was an effective and mature operation forcuring the severe deformity of knee. Total Knee Arthroplasty for thevalgus knee became a problem on account of unique pathological characterand it was still in controversial for operative approach,mathods of bonecutting,soft tissue balance and prosthesis selction etc.Themobile-bearings were used in TKA to improve the knee performance bysimulating more closely‘normal’ knee kinematics, and to increase thelongevity of TKA by reducing the polyethylene wear and periprostheticosteolysis.Since it was introduced in TKA,the mobile-bearings couldprovide satisfactory short and mid-term outcome. However,there was nosignificant differences in the clinical results compared with thefixde-bearing. There was relatively less researchs about mobile-bearingand fixed-bearing total knee arthroplasty for the valgus knee. And manyresearchs about comparsion between mobile-bearing and fixed-bearingaimed at varus knee or uncategorized the knee. So there was no separateand specific research for valgus knee.Objective:To evaluate the safety for mobile-bearing total knee arthroplasty forthe valgus knee by analyzing the key points of valgus knee and follow-upoutcome.To provide more clinical evidence for mobile-bearing bycomparying the eraly clinical outcomes of primary total knee arthroplastyin the valgus knee between mobile-bearing prosthesis and fixed-bearingprosthesis. Methods:Between January2011and January2014,17patients（23knees）performed by the same surgeon were selected for a retrospective study inThe First Hospital of Jilin University，including2males and15femaleswith a mean age of61.5years(48to75years).The pre-operative diagnosisinculded osteoarthritis(14patients,19knees) and rheumatoid arthritis(3patients,4knees).The patients with valgus deformity were divided intogroup A and group B.Fixed-bearing prosthesis and mobile-bearingprosthesis were respectively used in group A(9patients,12knees) andgroup B (8patients,11knees). And the date of the Knee Society Score(KSS),Hosptial for Special Surgery (HSS),Western Ontario MacMaster(WOMAC),the rang of motion (ROM)and femorotibial angle were collectedat pre-operation. The post-operative clinics follow-up was at onemonth,three months,six months,twelve months and every year. The KSS, HSS,WOMAC score and ROM were measured for clinical evaluation and standardAP and lateral radiographs,full length of lower limb radiographs weretaken to evaluate the position and fixation of prothesis and alignment.All date were analyzed statistically using SPSS22.0softwareResults:All patients were followed up6-36months (mean25months). Thevalgus deformity were corrected in all patients and there were significantdifference for all patients with regard to KSS knee score,functionscore,HSS score,WOMAC score,ROM and femorotibial angle betweenpre-operation and post-operation last follow-up(p﹤0.01).And there wereno significant differecces in KSS knee score,function score,HSSscore,WOMAC score, improvement in ROM and femorotibial angle between twogroups at last follow-up.However there were significant differecces inROM(p﹤0.05) between fixed-bearing group （101.8±8.8）°andmobile-bearing group（108.4±7.2）°at last follow-up.No spin-out of mobile bearing was observed.The were no complications such as infection,common peroneal nerve injury,dislocation,instability etc. in any patientand the radiological analysis showed no osteolysis or implant loosening.Conclusion:The eraly clinical outcomes of primary total knee arthroplasty byusing mobile-bearing prosthesis and fixed-bearing prosthesis weresatisfactory in the valgus knee and both of them were safe and reliablein TKA for valgus knee. The short-term clinical outcomes of mobile-bearingTKA and fixed-bearing TKA were similar. Even so the mobile-bearingprovided more choice for our use of prosthesis in TKA for valgus knee andpolyethylene wear and longevity of two types of prosthesis needs furtherlong-term research. |
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