Sahu Nabin K, Patnaik Smarajit, Nanda Saurav, Jain Mantu
Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, IND.
Orthopaedics, Apollo Hospital, Bhubaneswar, IND.
Cureus. 2019 Aug 27;11(8):e5501. doi: 10.7759/cureus.5501.
Introduction Range of motion (ROM) is a major desirable outcome after total knee arthroplasty (TKA). The aim of our study is to analyze the variables determining postoperative knee ROM, following cruciate-substituting TKA of arthritic knees. Methods One-hundred fourteen patients out of a total of 158 patients were studied on the basis of the inclusion criteria. All patients underwent cruciate-substituting TKA in the period between September 2014 and September 2017. Variables such as age, sex, body mass index (BMI), preoperative ROM, mild-to-moderate knee deformity (in both the sagittal and coronal planes) and knee society score (KSS) were recorded for all the patients. The patients were evaluated at intervals and finally at the end of one-year post-surgery. The final ROM and KSS were noted. Data were analyzed in SPSS system using the Kruskal-Wallis test and Mann-Whitney U test. Results Patients with younger age (less than 60 years), more preoperative ROM, and less preoperative fixed flexion deformity (FFD) were found to have better postoperative ROM. The mean preoperative KSS was 42.14 ± 12.02, which improved to 90.86 ± 3.86 postoperatively. Other variables like gender, BMI, and preoperative coronal plane deformity of mild to moderate degree did not have a significant influence on postoperative ROM. Conclusion Postoperative expectations of ROM is an important factor for a successful outcome and is also related to patient satisfaction. Variables like younger age group (less than 60 years), better preoperative ROM and lower preoperative FFD are found to have a better postoperative ROM in patients undergoing cruciate-substituting TKA surgery.
引言
活动范围(ROM)是全膝关节置换术(TKA)后主要的预期结果。我们研究的目的是分析决定患膝交叉韧带替代型TKA术后膝关节ROM的变量。
方法
根据纳入标准,在总共158例患者中对114例患者进行了研究。所有患者均在2014年9月至2017年9月期间接受了交叉韧带替代型TKA。记录了所有患者的年龄、性别、体重指数(BMI)、术前ROM、轻至中度膝关节畸形(矢状面和冠状面)以及膝关节协会评分(KSS)。对患者进行定期评估,最后在术后一年结束时进行评估。记录最终的ROM和KSS。在SPSS系统中使用Kruskal-Wallis检验和Mann-Whitney U检验对数据进行分析。
结果
发现年龄较小(小于60岁)、术前ROM较大且术前固定屈曲畸形(FFD)较小的患者术后ROM较好。术前KSS的平均值为42.14±12.02,术后提高到90.86±3.86。其他变量,如性别、BMI以及轻至中度术前冠状面畸形对术后ROM没有显著影响。
结论
术后ROM预期是成功结果的一个重要因素,也与患者满意度相关。在接受交叉韧带替代型TKA手术的患者中,发现年龄较小的组(小于60岁)、较好的术前ROM和较低的术前FFD术后ROM较好。