Lizaur-Utrilla Alejandro, Collados-Maestre Isabel, Miralles-Muñoz Francisco A, Lopez-Prats Fernando A
Department of Orthopaedic Surgery, Elda University Hospital, Elda, Alicante, Spain.
Department of Orthopaedic Surgery, Faculty of Medicine, Miguel Hernandez University, Elche, Alicante, Spain.
J Arthroplasty. 2015 Aug;30(8):1328-32. doi: 10.1016/j.arth.2015.02.032. Epub 2015 Feb 28.
A prospective matched cohort study was performed to compare outcomes of total knee arthroplasties (TKA) between 29 patients with posttraumatic osteoarthritis (POA) after a fracture of tibial plateau and 58 patients underwent routine TKA. Mean follow-up was 6.7 years. There were no significant differences in KSS, WOMAC, SF12 scores or range of motion. In the control group there were no complications. In the posttraumatic group, complications occurred in 4 patients (13.7%) (P=0.010) including partial patellar tendon detachment, superficial infection, skin necrosis, and knee stiffness. Only this last patient required revision for manipulation under anesthesia. Also, there was a revision for tibial aseptic loosening in each group. TKA is an effective treatment for POA after tibial plateau fracture. We recommend the prior removal of hardware, as well as tibial tubercle osteotomy when necessary.
进行了一项前瞻性配对队列研究，以比较29例胫骨平台骨折后创伤后骨关节炎（POA）患者与58例行常规全膝关节置换术（TKA）患者的全膝关节置换术结果。平均随访6.7年。膝关节协会评分（KSS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、简明健康调查量表12（SF12）评分或活动范围无显著差异。对照组无并发症。创伤后组有4例患者（13.7%）出现并发症（P = 0.010），包括部分髌腱断裂、浅表感染、皮肤坏死和膝关节僵硬。仅最后1例患者需要在麻醉下进行手法复位翻修。此外，每组均有1例因胫骨无菌性松动而进行翻修。TKA是治疗胫骨平台骨折后POA的有效方法。我们建议术前取出内固定物，必要时行胫骨结节截骨术。
