This study aimed to examine the clinical and radiographic outcomes of primary total knee arthroplasy（TKA） with use of Nex Gen#174; Legacy#174; Constrained Condylar Knee（CCK） prosthesis for severe knee deformity. C...This study aimed to examine the clinical and radiographic outcomes of primary total knee arthroplasy（TKA） with use of Nex Gen#174; Legacy#174; Constrained Condylar Knee（CCK） prosthesis for severe knee deformity. Clinical data of 46 patients（48 knees in total, aged 61 years on average） with severe knee deformity who underwent TKA with Nex Gen#174; Legacy#174; CCK prosthesis between December 2007 and February 2012 were retrospectively analyzed. There were 34 knees with severe valgus with incompetent medial collateral ligament, 11 knees with severe flexion contracture with inability to achieve knee balancing in flexion and extension by posterior soft tissue release, 2 knees with Charcot arthritis with severe varus and bone loss, and 1 with traumatic osteoarthritis with severe varus and ligamentous instability. The mean duration of follow-up was 71 months（range 40–90 months）. The New Knee Society scoring（NKSS） system and the Hospital for Special Surgery（HSS） score were used to evaluate the functional and clinical outcomes. Visual Analogue Scale（VAS） was used for pain measurement and Knee Society criteria for evaluation of radiological images. The results showed that, in the total 48 knees, 1 case of loosening due to short-stem tibial component at 3 months post-operatively underwent revision. The 6-year prosthesis survival rate in this cohort was 97.9%. There was no component infection occurring within 6 years. Significant post-operative improvements were found in NKSS and HSS scores. Patient satisfaction was significantly increased. Pain score was decreased significantly. Total functional score was improved from 31.46±11.43 to 86.42±8.87, range of motion（ROM） from 42.42°±23.57° to 95.31°±23.45° and the flexion contracture from 5.31°±7.87° to 0.92°±1.80°. Preoperative radiographic study showed excessive valgus（≥7°） in 37 knees, and varus deformity in 3 knees. Post-operative femorotibial alignment was valgus 3.88°±1.76° in 48 knees. Antero/posterior（A/P） view of X-ray films showed 4 radiolucent lines（RLL） in 48 tibial components. It was concluded that TKA with CCK is effective for the treatment of the severe unstable knee that cannot be balanced by soft tissue.展开更多
Malrotation following Total Knee Arthroplasty (TKA) is directly related to poor outcome. Knowledge of the rotational axes (torsion) and angles is therefore important. The aim of the study was to determine whether an a...Malrotation following Total Knee Arthroplasty (TKA) is directly related to poor outcome. Knowledge of the rotational axes (torsion) and angles is therefore important. The aim of the study was to determine whether an association existed between the Femoral Anteversion Angle (FAA) Posterior Condylar Angle (PCA) and the Inferior Condylar Angle (ICA) in individuals. A CT scan of 50 (25 paired) cadaver femora was made. The FAA, PCA and ICA were measured. Statistical analysis of comparative relationships between these different angles was examined by calculating Pearson correlation coefficients and a paired t-test. The mean FAA, PCA and ICA for the whole group were respectively 11.7° (range 0 - 32, SD 8.2), 5.18° (range 0 - 12, SD 2.4) and 4.4° (range 0 - 10, SD 2.1). A correlation of 0.82 (p = 0.01) of the FAA was found between left versus right. For the overall group a correlation coefficient between the PCA of the left and right femur was r = 0.59, p = 0.01. The Pearson correlation between the FAA and PCA in the whole group was r = 0.27, p = 0.06. In females this was r = 0.54 (p = 0.03). Although the difference of the mean ICA and PCA was very small (0.7°), there was no correlation between these angles (r = 0.14, p = 0.23). In conclusion, one should be aware that, considering the weak correlation of the FAA and PCA, an individual rotational variation exists. Furthermore, no correlation was found between the PCA and ICA. Therefore, for now, this angle cannot be assumed to be helpful in TKA. A more individual approach in total knee arthroplasty seems essential for future TKA.展开更多
目的:分析骨科行单髁膝关节置换术的患者在围手术期给予全面护理干预后的实际效果。方法:选取于2021年7月至2022年7月在蚌埠市第三人民医院骨科接受单髁膝关节置换术的患者110例作为研究对象,按照围手术期护理方式的不同随机分为常规护...目的:分析骨科行单髁膝关节置换术的患者在围手术期给予全面护理干预后的实际效果。方法:选取于2021年7月至2022年7月在蚌埠市第三人民医院骨科接受单髁膝关节置换术的患者110例作为研究对象,按照围手术期护理方式的不同随机分为常规护理组与全面护理干预组各55例,对比两组患者术后住院时间、护理满意度、美国特种外科医院膝关节评分(hospital for special surgery knee score,HSS)与生活质量。结果:全面护理干预组患者的术后住院时间短于常规护理组患者,护理满意度高于常规护理组患者(均P<0.05);全面护理干预组患者术后疼痛、功能、活动范围、肌力、屈曲畸形、关节稳定性项目评分均显著高于常规护理组患者(均P<0.05);术后5 d全面护理干预组患者生理功能(physical functioning,PF)、生理职能(role physical,RP)、躯体疼痛(bodily pain,BP)、总体健康(general health,GH)、活力(validity,VT)、社会功能(social function,SF)、情感职能(role emotional,RE)、精神健康(mental health,MH)评分显著高于常规护理组患者(均P<0.05)。结论:围手术期全面护理干预可以提升骨科单髁膝关节置换术患者的护理效果,能够在改善患者肢体功能的同时有效提升患者生活质量。展开更多
基金supported by a grant from the National Nature Science Foundation of China(No.81371973)
文摘This study aimed to examine the clinical and radiographic outcomes of primary total knee arthroplasy（TKA） with use of Nex Gen#174; Legacy#174; Constrained Condylar Knee（CCK） prosthesis for severe knee deformity. Clinical data of 46 patients（48 knees in total, aged 61 years on average） with severe knee deformity who underwent TKA with Nex Gen#174; Legacy#174; CCK prosthesis between December 2007 and February 2012 were retrospectively analyzed. There were 34 knees with severe valgus with incompetent medial collateral ligament, 11 knees with severe flexion contracture with inability to achieve knee balancing in flexion and extension by posterior soft tissue release, 2 knees with Charcot arthritis with severe varus and bone loss, and 1 with traumatic osteoarthritis with severe varus and ligamentous instability. The mean duration of follow-up was 71 months（range 40–90 months）. The New Knee Society scoring（NKSS） system and the Hospital for Special Surgery（HSS） score were used to evaluate the functional and clinical outcomes. Visual Analogue Scale（VAS） was used for pain measurement and Knee Society criteria for evaluation of radiological images. The results showed that, in the total 48 knees, 1 case of loosening due to short-stem tibial component at 3 months post-operatively underwent revision. The 6-year prosthesis survival rate in this cohort was 97.9%. There was no component infection occurring within 6 years. Significant post-operative improvements were found in NKSS and HSS scores. Patient satisfaction was significantly increased. Pain score was decreased significantly. Total functional score was improved from 31.46±11.43 to 86.42±8.87, range of motion（ROM） from 42.42°±23.57° to 95.31°±23.45° and the flexion contracture from 5.31°±7.87° to 0.92°±1.80°. Preoperative radiographic study showed excessive valgus（≥7°） in 37 knees, and varus deformity in 3 knees. Post-operative femorotibial alignment was valgus 3.88°±1.76° in 48 knees. Antero/posterior（A/P） view of X-ray films showed 4 radiolucent lines（RLL） in 48 tibial components. It was concluded that TKA with CCK is effective for the treatment of the severe unstable knee that cannot be balanced by soft tissue.
文摘Malrotation following Total Knee Arthroplasty (TKA) is directly related to poor outcome. Knowledge of the rotational axes (torsion) and angles is therefore important. The aim of the study was to determine whether an association existed between the Femoral Anteversion Angle (FAA) Posterior Condylar Angle (PCA) and the Inferior Condylar Angle (ICA) in individuals. A CT scan of 50 (25 paired) cadaver femora was made. The FAA, PCA and ICA were measured. Statistical analysis of comparative relationships between these different angles was examined by calculating Pearson correlation coefficients and a paired t-test. The mean FAA, PCA and ICA for the whole group were respectively 11.7° (range 0 - 32, SD 8.2), 5.18° (range 0 - 12, SD 2.4) and 4.4° (range 0 - 10, SD 2.1). A correlation of 0.82 (p = 0.01) of the FAA was found between left versus right. For the overall group a correlation coefficient between the PCA of the left and right femur was r = 0.59, p = 0.01. The Pearson correlation between the FAA and PCA in the whole group was r = 0.27, p = 0.06. In females this was r = 0.54 (p = 0.03). Although the difference of the mean ICA and PCA was very small (0.7°), there was no correlation between these angles (r = 0.14, p = 0.23). In conclusion, one should be aware that, considering the weak correlation of the FAA and PCA, an individual rotational variation exists. Furthermore, no correlation was found between the PCA and ICA. Therefore, for now, this angle cannot be assumed to be helpful in TKA. A more individual approach in total knee arthroplasty seems essential for future TKA.
文摘目的:分析骨科行单髁膝关节置换术的患者在围手术期给予全面护理干预后的实际效果。方法:选取于2021年7月至2022年7月在蚌埠市第三人民医院骨科接受单髁膝关节置换术的患者110例作为研究对象,按照围手术期护理方式的不同随机分为常规护理组与全面护理干预组各55例,对比两组患者术后住院时间、护理满意度、美国特种外科医院膝关节评分(hospital for special surgery knee score,HSS)与生活质量。结果:全面护理干预组患者的术后住院时间短于常规护理组患者,护理满意度高于常规护理组患者(均P<0.05);全面护理干预组患者术后疼痛、功能、活动范围、肌力、屈曲畸形、关节稳定性项目评分均显著高于常规护理组患者(均P<0.05);术后5 d全面护理干预组患者生理功能(physical functioning,PF)、生理职能(role physical,RP)、躯体疼痛(bodily pain,BP)、总体健康(general health,GH)、活力(validity,VT)、社会功能(social function,SF)、情感职能(role emotional,RE)、精神健康(mental health,MH)评分显著高于常规护理组患者(均P<0.05)。结论:围手术期全面护理干预可以提升骨科单髁膝关节置换术患者的护理效果,能够在改善患者肢体功能的同时有效提升患者生活质量。
