Cammisa Eugenio, Sassoli Iacopo, La Verde Matteo, Fratini Stefano, Rinaldi Vito Gaetano, Lullini Giada, Vaccari Vittorio, Zaffagnini Stefano, Marcheggiani Muccioli Giulio Maria
Orthopedic Unit, Imola Hospital, 40026 Imola, Italy.
II Orthopaedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli-DIBINEM, University of Bologna, Via di Barbiano, 1/10, 40100 Bologna, Italy.
J Clin Med. 2022 Nov 6;11(21):6580. doi: 10.3390/jcm11216580.
"Windswept" deformity (WSD) consists of a non-frequent condition in which the patient presents a valgus deformity in one knee and a varus deformity in the other. We performed a review of the available literature to aggregate the accessible data on the outcomes of bilateral knee arthroplasty in patients with WSD and to discuss the surgical challenges that this condition might pose.
A systematic review of the literature following the PRISMA guidelines was conducted. The relevant studies between 1979 and 2021 were identified. Four studies with a total of 68 patients were included for analysis. The mean follow-up for varus knees was 3.3 years, 3.1 years for valgus knees. The quality and rigor of the included studies was assessed using the Methodological index for non-randomized studies (MINORS).
All the studies reported improvement in knee function following knee replacement surgery, and a reduction in axial deviation of both knees, with similar results in valgus and varus knees in terms of patient satisfaction. The most relevant data were that unicompartmental knee arthroplasty (UKA) allowed for limited axial correction with slightly inferior functional results. Kinematic alignment (KA) allowed for similar results in both knees.
The present review shows how satisfactory results can be achieved in both knees in patients with WSD and osteoarthrosis (OA). However, the operating surgeon should be aware of the importance of the implant choice in terms of functional outcomes. In the absence of extra-articular deformities, calipered KA total knee arthroplasty (TKA) can be performed on both knees with good axial correction and functional outcome.
II -Systematic review of cohort studies.
“风吹”畸形（WSD）是一种不常见的病症，患者一侧膝关节呈外翻畸形，另一侧膝关节呈内翻畸形。我们对现有文献进行了综述，以汇总关于WSD患者双侧膝关节置换术结果的可获取数据，并讨论这种病症可能带来的手术挑战。
按照PRISMA指南对文献进行系统综述。确定了1979年至2021年间的相关研究。纳入四项研究，共68例患者进行分析。内翻膝关节的平均随访时间为3.3年，外翻膝关节为3.1年。使用非随机研究方法学指数（MINORS）评估纳入研究的质量和严谨性。
所有研究均报告膝关节置换术后膝关节功能有所改善，双膝的轴向偏差减小，外翻和内翻膝关节在患者满意度方面结果相似。最相关的数据是，单髁膝关节置换术（UKA）轴向矫正有限，功能结果略差。运动学对线（KA）在双膝上的结果相似。
本综述表明，WSD和骨关节炎（OA）患者的双膝均可取得令人满意的结果。然而，手术医生应意识到植入物选择对功能结果的重要性。在没有关节外畸形的情况下，可对双膝进行带测量的KA全膝关节置换术（TKA），获得良好的轴向矫正和功能结果。
II -队列研究的系统综述。
