Total knee arthroplasty for knee osteoarthritis

Abstract

Objective To estimate the short and mid-term effects of total knee arthroplasty(TKA) as well as to explore the surgical skills and postoperative effects. Methods A retrospective analysis was performed on the clinical data of 81 patients who received TKA between July 2010 and March 2018 in Yi-Ji-Shan Hospital of Wannan Medical College. The duration of disease ranged from one to 25 years, mean (8±3) years. Posterior stabilizing (PS) prosthesis was used for all the cases. After removal of osteophytes and osteotomy, selected soft tissue release was carried out to correct knee deformity. Post operative tranexamic acid was injected into articular cavity. Rehabilitative exercises were performed in early stage. X-ray pictures of full-length lower limb and knee were recorded pre- and post-operatively. The flexion and extend angles, internal and external varus angles were recorded. The operation time and drainage volumes were also recorded. Post-operative follow-up was performed in one, three, six, 12 and 24 months. The results were evaluated according to Knee Society score (KSS). Results The mean duration of follow-up was (22±5) months. The operation time was (71±6) min on average, the mean volume of drainage was (380±5) ml, mean tibiofemoral angle of knee was corrected to (1.3±1.0)° post-operation. Anterior pain occurred in four patients. No neurovascular injury was found, and force line of lower limb was corrected to normal. The X-ray films showed no evidence of obvious radiolucent line, osteolysis, prosthesis subsidence or limb alignment change. KSS of the last followed-up was significantly better than the preoperative score, which was significantly different (clinic t =-66, function t =-91.7, P<0.05). Conclusion By removing the osteophytes and selected soft tissue releasing, TKA can correct the deformity of knee osteoarthritis, and restore the force line of lower limb, improve range of motion and function of knee; the clinical effect is satisfactory. Key words: Knee joint; Arthroplasty; Osteoarthritis; Joint deformities, acquired