Total knee arthroplasty in patients with greater than 20 degrees flexion contracture
Total knee arthroplasty in patients with greater than 20 degrees flexion contracture
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DOI：
10.1016/j.otsr.2009.04.001
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发表时间：
2009-06-01
影响因子：
2.3
通讯作者：
Burdin, P.
中科院分区：
文献类型：
--
作者：
Massin, P.;Petit, A.;Burdin, P.
全膝关节置换术（TKA）是否能纠正与骨关节炎、炎症性疾病、血友病或创伤后后遗症相关的膝关节僵硬屈曲挛缩？回顾性分析了来自5个专业中心的107例TKA的结果。仅纳入伸展时屈曲挛缩大于或等于20度的膝关节，其中46例屈曲小于90度。由于关节置换术，伸展增加了20 +/- 6。第1组（仅屈曲挛缩，n = 61）和第2组（组合僵硬，n = 46）中的22 +/- 11度，其中总活动度增加了39 +/- 21度。总体而言，平均剩余屈曲挛缩为7 +/- 7度。术前严重僵硬的病例活动度改善更大。1年功能结果与最终残余屈曲挛缩相关。最后一次随访时的活动度不依赖于术前活动度，但第2组除外，第2组的最终术后活动度（ROM）与术前ROM相关。血友病是预后不良的一个因素。在手术结束时恢复完全伸展是强制性的，首先从骨赘中释放后囊和侧副韧带，其次在必要时延长股骨远端切口。研究类型：4级回顾性研究。(C)2009年Elsevier Masson SAS。All rights reserved.
Does total knee arthroplasty (TKA) correct the flexion contracture in knee stiffness associated with osteoarthritis, inflammatory disease, hemophilia or post-traumatic sequelae? The results of 107 TKAs from five specialized centers were retrospectively reviewed. Only knees with greater than or equal to 20 degrees flexion contracture on extension were included, 46 of which also had less than 90 degrees flexion. As a result of the arthroplasty, extension increased by 20 +/- 6. in group 1 (flexion contracture only, n = 61), and by 22 +/- 11 degrees in group 2 (combined stiffness, n = 46), in which the total range of motion increased of 39 +/- 21 degrees. Overall, mean residual flexion contracture was 7 +/- 7 degrees. Improvements in mobility were greater in the cases with severe preoperative stiffness. One-year functional results correlated with final residual flexion contracture. Mobility at last follow-up did not depend on preoperative mobility, except in group 2, in which the final postoperative range of motion (ROM) correlated with preoperative ROM. Hemophilia was a factor of poor prognosis. Recovering full extension at end of surgery is mandatory, by first releasing the posterior capsule and the collateral ligaments from their osteophytes, and secondly by extending the distal femoral cut where necessary.Type of study: Level 4 retrospective. (C) 2009 Elsevier Masson SAS. All rights reserved.