Londhe Sanjay Bhalchandra, Shah Ravi Vinod, Doshi Amit Pankaj, Subhedar Kavita, Ranade Atul, Antao Nicholas
Orthopedic Surgeon, Holy Spirit Hospital, Mahakali Caves Road, Andheri east , Mumbai, 400093 Maharashtra India.
Orthopedic Surgeon, Criticare Superspeciality Hospital , Mumbai, India.
Indian J Orthop. 2021 May 27;55(5):1144-1149. doi: 10.1007/s43465-021-00428-z. eCollection 2021 Oct.
Forgotten knee is the terminology which is used to describe a post-TKA patient who is completely unaware of his knee implant. The aim of the study is to determine whether preoperative diabetes negatively influences the achievement of forgotten knee status.
This is a retrospective cohort study. 300 patients (240 F:60 M) were studied. Patients were evaluated by an independent observer with FJS-12 score 2 weeks preop and at 6 weeks and 12 months after the operation. The patients with a FJS-12 score of ≥ 55 were considered to have achieved forgotten knee status. Out of 240 females, 96 had diabetes and out of 60 males, 18 had diabetes. Preoperative factors such as preop HBA1c, ROM, degree of deformity, VAS score and other associated co morbidities and postoperative factors such as HBA1c, ROM and hip-knee-ankle alignment were studied. Study was started with null hypothesis. The statistical difference was measured with Binominal proportion test and comparison of means test.
96 out of 144 non-diabetic females (66.67%) and 51 out of 96 diabetic females (53%) achieved forgotten knee status (statistically significant, value = 0.0336, Binominal proportion test). 27 out of 42 (65%) non-diabetic males and 12 out 18 diabetic males (66%) achieved forgotten knee status ( value = 0.9411). The FJS-12 score at 1 year for non-diabetic females and diabetic females was 58.6 mean ± 12.6 SD and 53.8 ± 17.6, respectively, which is statistically significant, value 0.0145. The FJS-12 at 1 year in non-diabetic and diabetic males was 60.1 ± 14.8 and 59.6 ± 17.3, respectively, value = 0.9097.
Diabetic females have less chance of achieving a forgotten knee status than non-diabetic females. This understanding will help the operating surgeon in the preoperative patient counseling and modify the patient expectations.
“遗忘膝”是用于描述全膝关节置换术后患者完全未意识到其膝关节植入物的术语。本研究的目的是确定术前糖尿病是否会对“遗忘膝”状态的达成产生负面影响。
这是一项回顾性队列研究。共研究了300例患者（女性240例，男性60例）。由一名独立观察者在术前2周、术后6周和12个月时采用FJS - 12评分对患者进行评估。FJS - 12评分≥55分的患者被认为达到了“遗忘膝”状态。在240名女性中，96名患有糖尿病；在60名男性中，18名患有糖尿病。研究了术前因素，如术前糖化血红蛋白（HBA1c）、关节活动度（ROM）、畸形程度、视觉模拟评分（VAS）以及其他相关合并症，以及术后因素，如HBA1c、ROM和髋 - 膝 - 踝对线情况。研究从无效假设开始。采用二项比例检验和均值比较检验来测量统计学差异。
144名非糖尿病女性中有96名（66.67%）达到了“遗忘膝”状态，96名糖尿病女性中有51名（53%）达到了该状态（具有统计学意义，p值 = 0.0336，二项比例检验）。42名非糖尿病男性中有27名（65%）达到了“遗忘膝”状态，18名糖尿病男性中有12名（66%）达到了该状态（p值 = 0.9411）。非糖尿病女性和糖尿病女性在1年时的FJS - 12评分分别为均值58.6±12.6标准差和53.8±17.6，具有统计学意义，p值为0.0145。非糖尿病男性和糖尿病男性在1年时的FJS - 12评分分别为60.1±14.8和59.6±17.3，p值 = 0.9097。
糖尿病女性达到“遗忘膝”状态的机会比非糖尿病女性少。这一认识将有助于手术医生在术前对患者进行咨询，并调整患者的期望。
