Lei Kai, Liu Li-Ming, Yang Peng-Fei, Xiong Ran, Fu De-Jie, Yang Liu, Guo Lin
Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), No. 30 Gaotanyan Street, Shapingba District, 400038, Chongqing, China.
Arthroplasty. 2022 Jan 7;4(1):7. doi: 10.1186/s42836-021-00105-4.
This study aimed to compare the short-term clinical results of slight femoral under-correction with neutral alignment in patients with preoperative varus knees who underwent total knee arthroplasty.
The medical records and imaging data were retrospectively collected from patients who had undergone total knee arthroplasty in our hospital from January 2016 to June 2019. All patients had varus knees preoperatively. Upon 1:1 propensity score matching, 256 patients (256 knees) were chosen and divided into a neutral alignment group (n=128) and an under-correction group (n=128). The patients in the neutral group were treated with the neutral alignment. In the under-correction group, the femoral mechanical axis had a 2° under-correction. The operative time, tourniquet time and the length of hospital stay in the two groups were recorded. The postoperative hip-knee-ankle angle, frontal femoral component angle and frontal tibial component angle were measured. Patient-reported outcome measures were also compared.
The operative time, tourniquet time and the length of hospital stay in the under-correction group were significantly shorter than the neutral alignment group (P<0.05). At the 2-year follow-up, the under-correction group had a larger varus alignment (P<0.05) and a larger frontal femoral component angle (P<0.05), and the frontal tibial component angles of the two groups were comparable. Compared with the neutral alignment group, the slight femoral under-correction group had significantly better patient-reported outcome measures scores (P<0.05).
For varus knees treated with total knee arthroplasty, alignment with a slight femoral under-correction has advantages over the neutral alignment in terms of the shorter operative time and better short-term clinical results.
III.
本研究旨在比较术前膝内翻患者接受全膝关节置换术时，股骨轻度欠矫正与中立位对线的短期临床结果。
回顾性收集2016年1月至2019年6月在我院接受全膝关节置换术患者的病历和影像资料。所有患者术前均为膝内翻。经1:1倾向评分匹配后，选取256例患者（256膝），分为中立位对线组（n = 128）和欠矫正组（n = 128）。中立组患者采用中立位对线治疗。在欠矫正组中，股骨机械轴有2°的欠矫正。记录两组的手术时间、止血带使用时间和住院时间。测量术后髋-膝-踝角、股骨假体前倾角和胫骨假体前倾角。还比较了患者报告的结局指标。
欠矫正组的手术时间、止血带使用时间和住院时间均显著短于中立位对线组（P < 0.05）。在2年随访时，欠矫正组有更大的内翻对线（P < 0.05）和更大的股骨假体前倾角（P < 0.05），两组的胫骨假体前倾角相当。与中立位对线组相比，轻度股骨欠矫正组患者报告的结局指标得分显著更好（P < 0.05）。
对于接受全膝关节置换术的膝内翻患者，股骨轻度欠矫正对线在手术时间较短和短期临床结果较好方面优于中立位对线。
III级。
