| ObjectiveThe effect of the change of femoral posterior condylar offset on the recovery of knee joint function after total knee arthroplasty has not been determined.The purpose of this study is to quantitatively group the changes of femoral posterior condylar offset after total knee arthroplasty,in order to analyze the range of changes conducive to the recovery of knee joint function,and to provide a reference basis for determining the amount of posterior femoral condyle osteotomy in knee arthroplasty.MethodsThis subject was a retrospective study,including patients who underwent post-stable total knee arthroplasty in the Department of Orthopaedics,Guangdong Hospital of traditional Chinese Medicine from January 2018 to June 2020,and were followed up regularly by telephone and outpatient revisit.The last out-patient follow-up period was 6 months after operation.According to the difference D of PCO before and after operation,the patients were divided into four groups:group 1,postoperative PCO was 2-4mm(2<D<4),group 2,postoperative PCO was 0-2mm(0≤D≤2),group 3,postoperative PCO was 0-2mm(-2≤D<0),and group 4,postoperative PCO was 2-4mm(-4≤D<-2).The range of motion of knee joint,visual analogue scale,American knee society score and forgotten joint scores were statistically tested by one-way analysis of variance.ResultsA total of 155 patients(155 knees)were included in this study,including 61 males and 94 females,with an average age of 67 years,an average body mass index of 22.86 kg/m2,and an average follow-up time of 6.3 months.According to the results of PCO measurement,each group was divided into three groups:37 cases,45 cases,42 cases and 31 cases respectively.There was no significant difference in demographic data among the three groups.The range of motion of knee joint in group 1 and 2 was significantly higher than that in the other two groups at 1 and 3 months after operation,and the difference was statistically significant(P<0.001).At 6 months after operation,the average degree of knee flexion in group 2 was the highest,followed by group 3,followed by group 1 and group 4,and the difference among the groups was statistically significant(P<0.001).VAS score:at the same observation time,the VAS score of each group had no significant difference between groups(P>0.05).KSS score:there was no significant difference in KSS function score between the two groups at the same observation time(P>0.05).The clinical score of KSS in groups 2 and 3 was better than that in groups 1 and 4 with greater postoperative PCO changes.One month after operation,there was significant difference in the total score of KSS among the groups(P<0.05),but there was no significant difference between the groups at 6 months after operation(P>0.05).FJS score:there was significant difference in FJS score among each group 6 months after operation(P<0.001).According to the score,the order was group 2>group 3>group 4>group 1,and there was significant difference between group 2 and other groups(P<0.001).ConclusionThe postoperative PCO is larger than that of the two groups before operation,the early postoperative knee flexion is larger,the total score of KSS is higher,and the advantage gradually decreases with the passage of time.While the postoperative PCO is close to that of the two groups before operation,the recovery of knee flexion and the improvement of KSS clinical score will have more long-term advantages,and the FJS score is higher.When the postoperative change of PCO is controlled between 0 and 2mm,it is most beneficial to the recovery of knee flexion and knee joint function,and the postoperative acceptance of patients is higher. |
PDF Full Text Request