Department of Orthopaedic Surgery, the first Medical Centre, Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, 100853, China.
Department of Orthopaedic Surgery, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Int Orthop. 2021 Jun;45(6):1463-1468. doi: 10.1007/s00264-020-04792-7. Epub 2020 Sep 9.
This study aimed to evaluate the safety and efficacy of fusiform capsulectomy of posterior capsule in correcting severe flexion contracture during total knee arthroplasty (TKA).
A retrospective analysis was performed in the patients who had preoperative severe flexion contracture (> 30 degrees) prior to TKA and received fusiform capsulectomy of posterior capsule during TKA between December 2013 and November 2018. Range of motion (ROM), knee functional score, forgotten joint score (FJS), post-operative complications, and radiographic results were collected and evaluated.
Twenty patients (32 knees) were enrolled in this study. The mean duration of follow-up was 27.19 ± 15.92 months. The flexion contracture improved from pre-operative 37.69 ± 11.79° to post-operative 5.78 ± 4.44° (p < 0.001), and ROM increased from pre-operative 63.50 ± 21.74° to post-operative 97.88 ± 13.20° (p < 0.001). KSS clinical score increased from pre-operative 32.94 ± 11.03 to post-operative 82.34 ± 10.73 (p < 0.001), and KSS function score increased from pre-operative 28.97 ± 18.43 to post-operative 68.75 ± 15.96 (p < 0.001). The post-operative FJS was 76.08 ± 2.14. There was no implant loosening, infection, obvious haematoma formation, resultant instability, neurovascular complications, or revision for any reasons in the cohort until the last follow-up.
The technique of fusiform capsulectomy of posterior capsule to correct the severe flexion contracture during primary TKA is safe and effective and could provide good short-term results.
本研究旨在评估在全膝关节置换术（TKA）中进行后囊梭形囊切开术矫正严重屈曲挛缩的安全性和有效性。
回顾性分析 2013 年 12 月至 2018 年 11 月期间在 TKA 前存在严重屈曲挛缩（>30°）并接受后囊梭形囊切开术的患者。收集并评估了关节活动度（ROM）、膝关节功能评分、遗忘关节评分（FJS）、术后并发症和影像学结果。
本研究共纳入 20 例（32 膝）患者。平均随访时间为 27.19±15.92 个月。术前屈曲挛缩从 37.69±11.79°改善至术后 5.78±4.44°（p<0.001），ROM 从术前 63.50±21.74°增加至术后 97.88±13.20°（p<0.001）。KSS 临床评分从术前 32.94±11.03 增加至术后 82.34±10.73（p<0.001），KSS 功能评分从术前 28.97±18.43 增加至术后 68.75±15.96（p<0.001）。术后 FJS 为 76.08±2.14。在最后一次随访时，该队列中没有发生假体松动、感染、明显血肿形成、不稳定、神经血管并发症或任何原因的翻修。
在初次 TKA 中，通过后囊梭形囊切开术矫正严重屈曲挛缩是安全有效的，可以提供良好的短期效果。
