Mavalankar Ashutosh Purushottam, Rani Shubha
Consultant Joint Replacement Surgeon, Dr. Jivraj Mehta Smarak Health Foundation, Ahmedabad, Gujarat, India.
Senior Director and Head -Biometrics and Data Management Synchron Research Services Pvt. Ltd. Ahmedabad, Gujarat, India.
Indian J Orthop. 2019 Mar-Apr;53(2):270-275. doi: 10.4103/ortho.IJOrtho_268_17.
Total knee arthroplasty (TKA) is a very successful operation for the treatment of end-stage arthritis of the knee joint. In spite of improvement in surgical technique, implant design, postoperative pain management, and rehabilitation, some patients are not satisfied with the outcome of the surgery. It is believed that high-flexion (H-F) activities such as cross-legged sitting and squatting are necessary for satisfaction after TKA in Indian patients due to cultural and social reasons. This has led to the development and marketing of implant designs allowing H-F after TKA without strong evidence in the literature.
We carried out a retrospective study to determine the level of satisfaction in 74 patients operated for 120 TKA over a 5 year period. This was determined on the basis of a satisfaction questionnaire which included questions to assess satisfaction regarding pain relief and ability to perform routine daily activities and high knee flexion activities such as squatting and cross-legged sitting.
Out of a total of 74 patients, 69 patients were overall satisfied with their TKA. Out of these, only 5 patients could squat or sit in a cross-legged position. Majority of the patients were satisfied with the pain relief and improvement in their capacity to work provided by TKA.
Ability to perform H-F activities after TKA is not a necessary prerequisite for satisfaction in Indian patients. Implant designs allowing H-F should be used in a selected group of patients with good preoperative knee flexion and specific requirements.
全膝关节置换术（TKA）是治疗膝关节终末期关节炎的一种非常成功的手术。尽管手术技术、植入物设计、术后疼痛管理和康复有所改进，但仍有一些患者对手术结果不满意。由于文化和社会原因，对于印度患者而言，全膝关节置换术后要获得满意效果，诸如盘腿坐和深蹲等高屈曲（H-F）活动被认为是必要的。这导致了一些允许全膝关节置换术后进行高屈曲活动的植入物设计的开发和销售，但文献中并无有力证据支持。
我们进行了一项回顾性研究，以确定74例患者在5年期间接受的120次全膝关节置换手术的满意度。这是根据一份满意度调查问卷确定的，该问卷包括一些问题，用于评估对疼痛缓解、进行日常活动的能力以及深蹲和盘腿坐等膝关节高屈曲活动的满意度。
在总共74例患者中，69例对其全膝关节置换术总体满意。其中，只有5例患者能够深蹲或盘腿坐。大多数患者对全膝关节置换术提供的疼痛缓解和工作能力改善感到满意。
全膝关节置换术后进行高屈曲活动的能力并非印度患者获得满意效果的必要前提条件。允许高屈曲的植入物设计应仅用于术前膝关节屈曲良好且有特定需求的特定患者群体。
