Mid-term outcomes of primary constrained condylar knee arthroplasty in severe deformity of knee

来源 :中华医学会第十八届骨科学术会议暨第十一届COA国际学术大会 | 被引量 : 0次 | 上传用户:dimaie
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
  Objective We used NexGen? Legacy? Constrained Condylar Knee (CCK) prosthesis as primary Total Knee Arthroplasy (TKA) in severe knee deformity and to compare its post operative outcomes in terms of clinical, radiological, functional situation, pain relief, and patient satisfaction with respect to expectation; as compared to pre operative status. Materials and Method We performed a retrospective study of 46 (48 knees) patients of a mean age of 61 years with severe knee deformity who underwent TKA with NexGen? Legacy? CCK prosthesis during the period of December 2007 and February 2012. The indications of use CCK prosthesis were severe valgus with incompetent medial collateral ligament in 34 knees, severe flexion contracture with inability to achieve knee balancing in flexion and extension by posterior soft tissue release in 11 knees, Charcot arthritis with severe varus and bone loss in 2 knees, traumatic osteoarthritis with severe varus and ligamentous instability in 1 knee. 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 as the tool to study the functional and clinical situation. Patients satisfaction, patients expectation, and respective scores were considered for analysis. Visual Analogue Scale (VAS) was used for pain. Factors affecting patients satisfaction were analyzed separately. We assessed the radiological situation using Knee Society criteria. Results For the total 48 knees, 1 case of loosening because of the short-stem tibial component at 3 months postoperatively underwent revision, the 6-year survival was 97.9%. There were no components infection occurred within 6 years. Parameters of NKSS and HSS system showed significant change postoperatively in comparison to their preoperative scores. The NKSS score improved from 30.52±14.22 to 89.69±8.37 from preoperative score to the mean 71 months follow-up. The HSS score improved from 35.95±15.74 to 71.40±25.16. Patient satisfaction was recorded to be improved significantly from 8.38±4.015 to 37.88±4.646 along with significant improvement in patient expectation from 10.31±1.662 to 14.31±1.138. Pain score was decreased from 6.29±2.25 to 1.21±1.09. 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°, the flexion contracture from 5.31° ± 7.87° to 0.92° ± 1.80°. Preoperative radiographic study showed excessive valgus (≥7°) in 37 knees, varus deformity in 2 knees, the postoperative femorotibial alignment was valgus 3.88° ±1.76° in 48 knees. A/P radiographic review showed there were 4 radiolucent lines (RLL) in 48 tibial components. Conclusion CCK TKA is a satisfactory modality for the treatment of the severe unstable primary knee that cannot be balanced by soft tissue. It is comparable to other widely studied prostheses designs with respect to functional regain, pain relief, improvement in ROM, and patient satisfaction.
其他文献
目的 结合美国国家癌症综合网络(NCCN)结直肠癌诊疗指南2015版标准及国外相关研究结果,评估青岛大学附属医院放射科关于直肠癌的MRI检查报告的完整性及规范化标准.方法选取我院107例直肠癌患者共110例直肠MRI检查报告,以NCCN指南为标准,以国外学者的相关研究为参考,评价本院直肠癌MRI报告对肿瘤的定位及病变范围(DIS)、肿瘤侵犯深度(T分期-T)、肛门复合体侵犯情况(A分期-A)
目的:研究一种新的 CT定位线指示灯光标精确性测试方法。 方法:设计一种新的CT定位线指示灯光标精确性测试工具,并用于CT定位线指示灯光标精确性测试。 结果:本种测试方法无需使用X线胶片和暗室冲洗,使用方便、经济,适用范围广泛。本种测试方法操作简便,只需一次曝光就可得出结果,无需多次调整测试板和多次曝光。本种测试方法结果解读简单,通过判读高密度小点的多少和出现方向即可判断CT定位线指示灯是否有偏差
目的 通过对X线气钡双重造影检查和胃镜检查对比,进一步明确这两种方法对该病的诊断价值。方法 分析36例疣状胃炎经气钡双重造影及胃镜检查结果,并经病理证实。结果 疣状胃炎呈多种形态改变,气钡双重造影多显示出粘膜表面多发圆形或椭圆形隆起,中心呈点状龛影,表面呈痘疮样糜烂,胃壁柔软,随充气量不同形态可改变。结论 气钡双重造影与胃镜检查各有利弊,综合两种技术,可提高诊断的标准性。
BackgroundCriss-crossheart(CCH)isararecongenitalheartdiseaseandalwaysassociatedwithcomplexanomalies.Accurate preoperativeevaluationofthedeformationisessentialforsuccessfulsur
目的 探讨IVIM参数D、f及D*值与局部进展期乳腺癌预后因子间的相关性,以期利用IVIM技术在活体评估乳腺癌预后的可行性.方法 经过术后病理证实的浸润性乳腺患者共69例76个病灶及6例导管原位癌患者纳入本组研究,所有病理标本均行常规的HE染色及免疫组织化学检查.所有患者均行常规MRI动态增强检查及多b值IVIM检查(b=0,10,20,30,50,70,100,150,200,
目的 研究乳腺良恶性病变的高b值拉伸指数DWI的特点,并比较其与常规单指数DWI在鉴别乳腺良恶性病变的能力方法77位患者包括52个恶性病变、20个良性病变、18个单纯性囊肿及23例对侧正常的乳腺组织纳入本组研究中.所有患者均行常规乳腺动态增强MRI检查及高b值(b=0,700,1400,2100sec/mm2)DWI检查.计算正常乳腺组织及病变的常规单指数DWI的ADC值及拉伸指数模型的
ObjectiveInthisstudy,toenhancethediagnosisofnon-smallcelllungcancer(NSCLC),wepreparedadual-modalprobeCy5.5-Tf-Gd-DTPA. Methods Inthispaper,wedescribethatthetransferrin,whe
目的 国内外关于儿童脐部相关疾病影像表现的文章多为病例报道,需要总结以加深认识.方法 回顾性收集并分析本院2010-2016年儿童脐部相关疾病的影像表现,并搜集文献进行分析.结果 儿童脐部相关疾病包括:1.脐静脉开放及插管;2.脐膨出;3.脐疝;4.与泌尿系相关疾病:脐尿管瘘、囊肿及感染;5.与卵黄管相关疾病:脐肠瘘、meckel憩室;6.其它畸形:如cantrell综合征等.每种疾病的影像表
目的 探讨音乐疗法对动脉瘤介入术后患者焦虑及抑郁情绪的影响.方法选取动脉瘤介入术后患者60例,随机分为对照组和试验组,每组各30例.对照组给予动脉瘤介入术后常规护理,试验组在对照组常规护理的基础上加用音乐疗法,比较两组患者的焦虑、抑郁程度.结果 对照组和试验组患者在性别、年龄、文化程度、住院费用支付方式方面,经统计学检验,差异均无统计学意义.两组间比较,手术后当天(未行音乐疗法前)试验组和
目的 整合资源,优化RIS,简化流程,便于科室管理。方法 我院2006年引进PACS/RIS,十年来检查人次近300万,日平均登记为1000人次,RIS版本升级10余次。一、预约登记模块1、实行电子医嘱:通过与HIS整合,患者在临床医生处开具电子医嘱后直接到收费处交费,无需到放射科划价,简化流程。2、信息整合:登记员登记时,直接通过HIS接口,取回患者自然信息和检查信息。好处:减轻