Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt.
Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
J Orthop Surg Res. 2019 May 31;14(1):168. doi: 10.1186/s13018-019-1180-3.
Post-traumatic arthritis is one of the leading causes of joint disability. This study aims at outlining outcomes of total knee arthroplasty in post-traumatic arthritis and technical difficulty and reviewing literature regarding this issue PATIENTS AND METHODS: We analyzed the outcome of total knee arthroplasty following post-traumatic arthritis in 15 patients with unilateral involvement. Ten had stable arthritic knees treated with posterior stabilized (PS) prosthesis, while five with unstable arthritic knees treated as follows: three with ligamentous instability managed by constrained condylar prosthesis and two with osseous deficiency, metal augmentation used together with stemmed constrained condylar prosthesis (CCK). Average follow-up 6 years, mean age 49.8 years at time of arthroplasty. Patient outcomes were evaluated on the basis of Knee Society score.
Mean clinical knee society scores (CKSS) at latest follow-up improved from 43.6 ± 11.66 points to 77.3± points postoperatively while mean functional knee society score (FKSS) improved from 40. ± 6.3 to 76.6 ± 84 postoperatively. Patients with stable knees had a higher mean values, both clinical and functional KSS, while unstable knees were poorer. Complications occurred in three cases, one with wound dehiscence with prolonged drainage treated by antibiotics and daily dressings until the wound closed completely, one was complicated by infection and improved by serial debridement, and the third case had aseptic loosening which required revision surgery.
Total knee arthroplasty for post-traumatic arthritis decreases pain and improves knee function. However; the procedure is not as simple as primary arthroplasty as it is technically demanding and requires adequate planning.
创伤后关节炎是导致关节残疾的主要原因之一。本研究旨在概述创伤后关节炎全膝关节置换术的结果和技术难度，并复习相关文献。
我们分析了 15 例单侧受累的创伤后关节炎患者全膝关节置换术的结果。10 例稳定型关节炎患者采用后稳定型（PS）假体治疗，5 例不稳定型关节炎患者如下治疗：3 例韧带不稳定患者采用约束性髁假体治疗，2 例骨缺损患者采用金属增强与带柄约束性髁假体（CCK）联合治疗。平均随访 6 年，关节置换时平均年龄为 49.8 岁。根据膝关节协会评分评估患者的结果。
末次随访时，平均临床膝关节协会评分（CKSS）从 43.6±11.66 分提高到 77.3±分，平均功能膝关节协会评分（FKSS）从 40.±6.3 分提高到 76.6±84 分。稳定膝关节患者的平均 CKSS 和 FKSS 值均较高，而不稳定膝关节患者较差。3 例患者发生并发症，1 例切口裂开，伴长时间引流，经抗生素和每日换药直至伤口完全闭合；1 例感染，经多次清创术改善；1 例无菌性松动，需行翻修手术。
创伤后关节炎行全膝关节置换术可减轻疼痛，改善膝关节功能。然而，与初次关节置换术相比，该手术技术要求较高，需要充分规划，并非简单的手术。
