Onoi Yuma, Matsumoto Tomoyuki, Nakano Naoki, Tsubosaka Masanori, Kamenaga Tomoyuki, Kuroda Yuichi, Ishida Kazunari, Hayashi Shinya, Kuroda Ryosuke
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan.
Department of Orthopaedic Surgery, Kobe Kaisei Hospital, Kobe, Japan.
Indian J Orthop. 2024 Feb 6;58(3):308-315. doi: 10.1007/s43465-023-01094-z. eCollection 2024 Mar.
Total knee arthroplasty (TKA) for Charcot arthropathy of the knee is considered controversial because of its higher complication rate compared with that of TKA for osteoarthritis. In this study, we investigated the clinical outcomes, survival rates, and complications of primary TKA for Charcot arthropathy.
We conducted a retrospective analysis of nine patients (12 knees) with Charcot arthropathy who underwent TKA. The mean age of the patients was 63.9 ± 9.4 years (range, 52-83 years). The most frequent causative disease was diabetes mellitus (three patients). Patients' clinical outcomes, including the 2011 Knee Society Score and the range of motion, were compared between preoperative and the most recent postoperative data. The 5- and 10-year survival rates for aseptic revision, revision due to infection, and complications were examined. The mean follow-up period was 7.3 ± 3.9 years (range, 3-14 years).
The 2011 Knee Society Score and the knee flexion angle significantly improved after TKA surgery ( < 0.05). The 5-year survival rates for aseptic revision, revision due to infection, and complications were 100%, 91.7%, and 83.3%, respectively; the 10-year survival rates for these parameters were the same. One patient underwent revision for insert replacement due to periprosthetic infection, and the other patient had varus/valgus instability due to soft tissue loosening.
The mid- to long-term results of TKA for Charcot arthropathy were generally favorable. Our findings indicate that TKA may be a viable treatment option for Charcot arthropathy.
与骨关节炎的全膝关节置换术(TKA)相比,膝关节夏科氏关节病的TKA因其更高的并发症发生率而存在争议。在本研究中,我们调查了原发性TKA治疗夏科氏关节病的临床结果、生存率和并发症。
我们对9例(12膝)接受TKA的夏科氏关节病患者进行了回顾性分析。患者的平均年龄为63.9±9.4岁(范围52 - 83岁)。最常见的致病疾病是糖尿病(3例患者)。比较患者术前和最近一次术后数据的临床结果,包括2011年膝关节协会评分和活动范围。检查无菌翻修、感染翻修和并发症的5年和10年生存率。平均随访期为7.3±3.9年(范围3 - 14年)。
TKA手术后,2011年膝关节协会评分和膝关节屈曲角度显著改善(<0.05)。无菌翻修、感染翻修和并发症的5年生存率分别为100%、91.7%和83.3%;这些参数的10年生存率相同。1例患者因假体周围感染接受了植入物置换翻修,另1例患者因软组织松动出现内翻/外翻不稳定。
TKA治疗夏科氏关节病的中长期结果总体良好。我们的研究结果表明,TKA可能是治疗夏科氏关节病的一种可行选择。