Total knee arthroplasty for valgus osteoarthritis: the results of a standardized soft-tissue release technique
Total knee arthroplasty for valgus osteoarthritis: the results of a standardized soft-tissue release technique
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DOI：
10.1007/s00167-016-4054-9
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发表时间：
2016-08-01
影响因子：
3.8
通讯作者：
Faschingbauer, Martin
中科院分区：
文献类型：
--
作者：
Boettner, Friedrich;Renner, Lisa;Faschingbauer, Martin
该研究报告了接受标准化软组织松解的全膝关节置换术（TKA）的外翻骨关节炎患者的2年随访结果。2008年至2013年间，一名外科医生为外翻骨关节炎进行了222例全膝关节置换术。164例患者的181例TKA可用于至少2年随访（范围24-87个月）。术前和术后活动度（ROM）、机械对线、术后胫骨近端内侧角（MPTA）、西安大略和麦克马斯特大学关节炎指数（WOMAC）、VF-12评分、视觉模拟疼痛量表（VAS）和实际UCLA活动评分、预期UCLA评分，韧带稳定性记录了膝关节内侧副韧带（内侧副韧带）和并发症以及翻修率。ROM从术前4.7A度屈曲挛缩增加术后平均屈曲挛缩0.1A度（范围-5至10），屈曲128 A度（范围100-140）。平均髋-膝-踝对线从8.4A度的机械外翻（范围5.3-25.4）变为0.02A度的内翻对线（范围-2.9至4.1）。胫骨组件角（MPTA）为90.4A度（范围86.1-93.7）。术后WOMAC评分、VF-12、UCLA和VAS评分均明显改善（p < 0.05）。2例患者（1.1%）因膝关节不稳接受了翻修手术。所描述的标准化软组织松解（松解髂胫束和后外侧角）在至少2年的随访中提供了极好的临床结果，并且可以安全地用于外翻膝关节的“食谱”方法，最高可达25 A度机械外翻。IV.
The study reports the 2-year follow-up results of patients with valgus osteoarthritis undergoing total knee arthroplasty (TKA) with a standardized soft-tissue release.Between 2008 and 2013, 222 TKAs were performed for valgus osteoarthritis by a single surgeon. A total of 181 TKAs in 164 patients were available for a minimum 2-year follow-up (range 24-87 months). Preoperative and postoperative range of motion (ROM), mechanical alignment, the postoperative medial proximal tibial angle (MPTA), Western Ontario and McMaster Universities Arthritis Index (WOMAC), VF-12 score, visual analogue pain scale (VAS), and the actual UCLA activity score, desired UCLA score, ligamentous stability (medial collateral ligament) and complications and revision rates were recorded.The ROM increased from a preoperative flexion contracture of 4.7A degrees (range 0-40) and flexion of 110A degrees (range 35-135) to a postoperative mean flexion contracture of 0.1A degrees (range -5 to 10) and flexion of 128A degrees (range 100-140). The mean hip-knee-ankle alignment was changed from 8.4A degrees of mechanical valgus (range 5.3-25.4) to 0.02A degrees of varus alignment (range -2.9 to 4.1). Tibia component angle (MPTA) was 90.4A degrees (range 86.1-93.7). The WOMAC score, VF-12, UCLA and VAS significantly improved after surgery (p < 0.05). Two patients (1.1 %) underwent revision surgery for instability.The described standardized soft-tissue release (release of the iliotibial band and posterolateral corner) provided excellent clinical results at a minimum 2-year follow-up and can be used safely for a "cook-book" approach to the valgus knee with up to 25A degrees mechanical valgus alignment.IV.