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全膝关节置换术治疗严重骨关节炎畸形患者的下肢长度差异。

The difference in leg lengths following total knee replacement for patients with severe osteoarthritic deformity.

机构信息

The Orthopedic Department, Faculty of Medicine, October 6 University, Giza, Egypt.

The Orthopaedic Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.

出版信息

Int Orthop. 2023 Dec;47(12):3001-3006. doi: 10.1007/s00264-023-05948-x. Epub 2023 Aug 31.

Abstract

PURPOSE

Increased height after total knee replacement surgery (TKR) may offer patients higher satisfaction as well as the quality of life. Therefore, in this paper, we aim to document the changes in leg length after TKR in patients with severe bilateral deformities.

METHODS

The data of 61 patients were collected from the Egyptian Community Arthroplasty Register; of them, 21 patients had unilateral TKR while 40 had bilateral simultaneous TKR. The patterns of changes in height of 101 osteoarthritic knees were followed up for 1 year after having TKR. All patients had standing leg X-rays, before and after surgery, to document the length of the femur and tibia before and after TKR. Correlations were assessed using the two-sample t-test.

RESULTS

The sample was mostly females (56/61, 91.8%). The distribution of the operated side was nearly equal (right knee was 47/101, 46.5%). The overall average leg length difference was 5.4 (SD = 2.3); for the unilateral group, the average was 4.6 (SD = 2.6); and for the bilateral group, the average was 5.6 (SD = 2.3), p = 0.119. We found that leg length may differ according to the varus deformity angle (p < 0.001) as well as fixed flexion deformity (p < 0.001).

CONCLUSIONS

Leg length increased significantly 1 year after TKR. However, there is not enough evidence to suggest that the bilateral group had a greater height increase when compared to the unilateral group.

摘要

目的

全膝关节置换术(TKR)后增加的身高可能会为患者带来更高的满意度和生活质量。因此,本文旨在记录严重双侧畸形患者 TKR 后腿长的变化。

方法

从埃及社区关节置换登记处收集了 61 名患者的数据;其中,21 名患者接受了单侧 TKR,40 名患者接受了双侧同期 TKR。对 101 例骨关节炎膝关节的高度变化模式进行了 1 年的随访。所有患者均在术前和术后进行站立位下肢 X 线检查,以记录 TKR 前后股骨和胫骨的长度。使用双样本 t 检验评估相关性。

结果

样本中女性居多(56/61,91.8%)。手术侧的分布几乎相等(右膝 47/101,46.5%)。总的平均腿长差异为 5.4(SD=2.3);单侧组平均为 4.6(SD=2.6);双侧组平均为 5.6(SD=2.3),p=0.119。我们发现腿长可能因内翻畸形角度(p<0.001)和固定屈曲畸形(p<0.001)而有所不同。

结论

TKR 后 1 年内腿长显著增加。然而,没有足够的证据表明双侧组的身高增加比单侧组更大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24d8/10673729/6be9a4496c3f/264_2023_5948_Fig1_HTML.jpg

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