Liu Hao-Chen, Kuo Feng-Chih, Huang Chung-Chen, Wang Jun-Wen
Orthopedics. 2015 Feb;38(2):e112-7. doi: 10.3928/01477447-20150204-58.
Patients with severe varus deformity of the knee (≥15° varus) usually are not considered good candidates for minimally invasive total knee arthroplasty (TKA). The goal of this study was to retrospectively investigate outcomes in patients with severe varus deformity after minimally invasive TKA. A study group of 52 patients with a tibiofemoral mechanical axis of 195° or greater was compared with a matched control group of 55 patients with a tibiofemoral mechanical axis of less than 195°. Clinical and radiographic evaluations according to the American Knee Society rating system were obtained preoperatively and postoperatively, and postoperative patient satisfaction in the 2 groups was compared. All patients were followed at a mean of 3 years (range, 2-5 years). Preoperatively, clinical knee and function scores and range of motion were inferior in the study group compared with the control group (P<.001). However, at the latest follow-up, both groups of patients were satisfied with the clinical results, and no significant differences were found in the knee and function scores (P>.05). Radiographic evaluation showed no differences in the mechanical axis, femoral component valgus angle, and tibial component valgus angle, and all outliers of the radiographic parameters between the 2 groups postoperatively (P >.05). The study results showed that mini-midvastus TKA did not result in more inaccurate implant positioning in patients with severe varus deformity of the knee. The clinical outcome in the group with severe varus was comparable to that in the group with less severe varus
膝关节严重内翻畸形（≥15°内翻）的患者通常不被认为是微创全膝关节置换术（TKA）的理想候选者。本研究的目的是回顾性调查微创TKA术后严重内翻畸形患者的结局。将52例胫股机械轴为195°或更大的患者组成的研究组与55例胫股机械轴小于195°的匹配对照组进行比较。术前和术后根据美国膝关节协会评分系统进行临床和影像学评估，并比较两组患者术后的满意度。所有患者平均随访3年（范围2 - 5年）。术前，研究组的临床膝关节和功能评分以及活动范围均低于对照组（P<0.001）。然而，在最近的随访中，两组患者对临床结果均满意，膝关节和功能评分无显著差异（P>0.05）。影像学评估显示，机械轴、股骨假体外翻角和胫骨假体外翻角无差异，两组术后影像学参数的所有异常值（P>0.05）。研究结果表明，微创股中肌入路TKA在膝关节严重内翻畸形患者中不会导致植入物定位更不准确。严重内翻组的临床结局与轻度内翻组相当。
