Knee Surgery Center, Instituto Nacional de Traumatologia e Ortopedia (INTO), Av. Brasil, 500, São Cristóvão, Rio de Janeiro, RJ, 20940-070, Brazil.
, Rio de Janeiro, Brazil.
Int Orthop. 2019 Sep;43(9):2065-2070. doi: 10.1007/s00264-018-4147-9. Epub 2018 Sep 14.
To assess functional outcomes in patients undergoing total knee arthroplasty (TKA) without previous corrective osteotomy for treatment of knee osteoarthritis associated with extra-articular deformity.
From January to December 2016, patients with knee osteoarthritis with extra-articular deformities who presented for preoperative assessment before TKA were evaluated prospectively. Physical and radiological characteristics were documented pre- and postoperatively.
TKA was performed in 33 knees; 25 were considered for analysis. The mean age was 65.2 years (range, 48-79 years). Sixteen deformities were secondary to fractures and nine to failed osteotomies. The mean Knee Society Score (KSS) improved from 27.1 pre-operatively to 68.7 post-operatively (p = 0.000). Pre-operative mechanical axis ranged from 32° varus (negative) to 26° valgus. After correction, 20 knees were within 3° (varus or valgus) of mechanical alignment.
In patients with extra-articular deformities, TKA with asymmetric intra-articular resection and ligament balancing can relieve pain and realign the mechanical axis of the lower limb.
评估因膝关节骨关节炎伴发关节外畸形而行初次全膝关节置换术（TKA）治疗且术前未行矫正性截骨术患者的功能结局。
2016 年 1 月至 12 月，前瞻性评估了因术前 TKA 评估而就诊的伴发关节外畸形的膝关节骨关节炎患者。记录了术前和术后的体格检查和影像学特征。
33 膝行 TKA 治疗，其中 25 膝纳入分析。平均年龄为 65.2 岁（48-79 岁）。16 例畸形继发于骨折，9 例继发于截骨失败。膝关节学会评分（KSS）由术前的 27.1 分提高至术后的 68.7 分（p=0.000）。术前机械轴范围为 32°内翻（负角）至 26°外翻。术后，20 膝机械轴在 3°（内翻或外翻）以内。
在伴发关节外畸形的患者中，行不对称性关节内切除和韧带平衡的 TKA 可缓解疼痛并重新对线下肢机械轴。
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