Mittal Amber, Bhosale Pradeep B, Suryawanshi Ashish V, Purohit Shaligram
Department of Orthopaedics, Seth GS Medical College and KEM hospital, Mumbai, India.
J Orthop Surg (Hong Kong). 2013 Aug;21(2):199-203. doi: 10.1177/230949901302100217.
PURPOSE. To evaluate the outcome of one-stage long-stem total knee arthroplasty (TKA) for patients with arthritic knees and tibiofemoral stress fractures. METHODS. Records of 11 men and 18 women aged 47 to 78 (mean, 66) years who underwent fixed-bearing posterior-stabilised TKA for osteoarthritis or rheumatoid arthritis of the knee with tibial (n=31) and femoral (n=3) stress fractures were reviewed. All the tibial fractures involved the proximal half. There were 7 associated fibular stress fractures. Of the 31 knees with tibial stress fractures, 26 and 5 manifested varus and valgus deformity, respectively. RESULTS. The mean follow-up period was 51 (range, 24-96) months. The mean tibiofemoral angle improved from 23.2 to 1.9 degrees varus. The mean Knee Society knee score improved from 38.5 (range, 15- 63) to 89.6 (range, 80-95) [p<0.05]. The mean Knee Society functional score improved from 25.5 (range, 0-40) to 86.5 (range, 60-100) [p<0.05]. All fractures were united at the last follow-up. No complications were encountered. CONCLUSION. One-stage long-stem TKA restores limb alignment and facilitates fracture healing, with excellent outcome.
目的。评估一期长柄全膝关节置换术（TKA）治疗膝关节炎合并胫股应力性骨折患者的疗效。方法。回顾了11名男性和18名女性患者的记录，年龄在47至78岁（平均66岁），他们因膝关节骨关节炎或类风湿关节炎合并胫骨（n = 31）和股骨（n = 3）应力性骨折接受了固定平台后稳定型TKA。所有胫骨骨折均累及近端一半。有7例合并腓骨应力性骨折。在31例胫骨应力性骨折的膝关节中，26例和5例分别表现为内翻和外翻畸形。结果。平均随访期为51个月（范围24 - 96个月）。胫股角平均从内翻23.2度改善至1.9度。膝关节协会膝关节平均评分从38.5分（范围15 - 63分）提高到89.6分（范围80 - 95分）[p < 0.05]。膝关节协会功能平均评分从25.5分（范围0 - 40分）提高到86.5分（范围60 - 100分）[p < 0.05]。在最后一次随访时所有骨折均愈合。未出现并发症。结论。一期长柄TKA可恢复肢体对线并促进骨折愈合，疗效极佳。
