Clinical Efficacy And Surgical Technique Of Total Knee Arthroplasty With Terminal Stage Disease Of Knee With Deformity Of Knee

Objective:To investigate the end-stage knee joint disease associated with knee valgus deformity in patients with total knee replacement and the clinical curative effect of surgical methods.Methods:To collect The second hospital of Shanxi Medical University in January 2008 to december 2014, a total of 44 cases 46 knees of knee combined valgus deformity of the knee end patients with end-stage arthropathy of the knee joint, osteoarthritis in 33 cases34 knees, rheumatoid arthritis in 12 cases in 13 knees, male 10 cases, 34 female patients,ranging in age from 47 to 76 years, mean 60.5 years. Statistics of patients with preoperative knee flexion extension activity(ROM), X- ray tablets measured in femoral tibial angle(FTA), Knee Society scoring system(KSS) clinical score, functional scores and operation at the end of the follow-up of the index and postoperative complications.Surgery by the patellar medial approach, using the conventional method of osteotomy,right lateral soft tissue release, no patella replacement.Results:All patients were healed by first intention. All patients were followed up for 1 to 6years with an average of 3.8 years. Preoperative knee flexion and extension activity(ROM) was(75.23 + 13.45) degree, and the last follow-up was(104.91 + 10.24) degrees,the difference was statistically significant(P < 0.05). The femoral tibial angle(FTA) was measured by X before operation(18.36 + 6.82), and the last follow-up was(7.21 + 2.51),the difference was statistically significant(P < 0.05). Preoperative Knee Society scoring system(KSS) clinical score was(39.36 + 10.38) points, functional score(38.78 + 7.54)points. At the end of the follow-up KSS clinical score for(84.17 + 5.77), function score(84.57 + 4.80), compared with preoperative differences were statistically significant(P <0.05). 3 cases of knee using Nex Gen RHK rotating hinge knee prosthesis(Zimmer), 7patients(7 knees with constrained condylar prosthesis(constrained plate knee CCK)(LCCK, Zimmer), the rest were not preserved posterior cruciate ligament prosthesis(after stable type of Smith & nephew). One case of common peroneal nerve injury and recovery after symptomatic treatment. Others did not appear adverse, tracking of the patella 、prosthesis infection and other complications.Conclusion:knee valgus deformity of the final stage arthropathy of the knee joint implementation of artificial total knee replacement surgery, using anteromedial approach and operation with conventional osteotomy, proper release of soft tissue on the lateral,tightening medial collateral ligament when necessary, can effectively improve the knee valgus deformity and restore joint function, curative effect satisfaction.