Shah Vikram I, Patil Jayesh, Shetty Gautam M, Trivedi Parth
Shalby Ltd., Ahmedabad, Gujarat, India.
Department of Joint Replacement and Trauma Surgery, Shalby Hospital, Ahmedabad, Gujarat, India.
J Orthop Case Rep. 2024 Jun;14(6):171-176. doi: 10.13107/jocr.2024.v14.i06.4542.
The results of primary total knee replacement (TKR) using hinge implants performed in the Indian population with post-polio residual paresis (PPRP) are unknown. The purpose of this study was to report the outcome of primary rotating hinge TKR in Indian patients with PPRP at a minimum follow-up of 12 months.
We retrospectively reviewed the clinical and radiological records of six patients treated with primary rotating hinge TKR. Pre-and post-operative (at final follow-up) knee range of motion (ROM), knee sagittal deformity, knee society score (KSS), and Oxford knee score (OKS) were compared to determine improvement in function.
Six rotating hinge TKRs (five female and one male patient) were analyzed for this study. At a mean follow-up of 27 ± 22 months (range, 12-71 months), the mean pre-operative KSS of 50.6 ± 2.5 significantly improved (P < 0.0001) to 72.5 ± 1.6, and the mean pre-operative OKS of 23.6 ± 1.6 significantly improved (P < 0.0001) to 35.3 ± 1.7. The mean pre-operative knee ROM of 94° ± 10° changed to 92° ± 4° (P = 0.64) and the mean pre-operative sagittal deformity of 7° ± 23.5° changed to -3° ± 2.5° (P = 0.32) at final follow-up. None of the knees had any intra- or post-operative complications or showed radiologic evidence of post-operative loosening, subsidence, or periprosthetic radiolucent lines at the final follow-up.
Rotating hinge TKR gave excellent clinical and radiological results at a mean follow-up of 27 months in the present study. Despite TKR being a technically challenging procedure in patients with poliomyelitis-affected limbs, a rotating hinge design, along with meticulous surgical technique, can significantly improve function in such patients.
在患有小儿麻痹后遗症（PPRP）的印度人群中使用铰链式植入物进行初次全膝关节置换（TKR）的结果尚不清楚。本研究的目的是报告在印度患有PPRP的患者中进行初次旋转铰链式TKR且至少随访12个月的结果。
我们回顾性分析了6例行初次旋转铰链式TKR患者的临床和放射学记录。比较术前和术后（最终随访时）的膝关节活动范围（ROM）、膝关节矢状面畸形、膝关节协会评分（KSS）和牛津膝关节评分（OKS），以确定功能改善情况。
本研究分析了6例旋转铰链式TKR（5例女性和1例男性患者）。平均随访27±22个月（范围12 - 71个月），术前KSS平均为50.6±2.5显著改善（P < 0.0001）至72.5±1.6，术前OKS平均为23.6±1.6显著改善（P < 0.0001）至35.3±1.7。最终随访时，术前膝关节ROM平均94°±10°变为92°±4°（P = 0.64），术前矢状面畸形平均7°±23.5°变为 - 3°±2.5°（P = 0.32）。最终随访时，所有膝关节均无任何术中或术后并发症，也未显示出术后松动、下沉或假体周围透亮线的放射学证据。
在本研究中，旋转铰链式TKR在平均随访27个月时取得了优异的临床和放射学结果。尽管TKR在受小儿麻痹症影响肢体的患者中是一项技术上具有挑战性的手术，但旋转铰链设计以及细致的手术技术可显著改善此类患者的功能。
