Kamlay Pranav, Bagewadi Rajkumar, Khodnapur Gireesh, Bulagond Anil, Biradar Bhimangouda S, Nandi Santosh
Orthopaedics, Shri B M Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura, IND.
Orthopaedic Surgery, Shri B M Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura, IND.
Cureus. 2025 Jun 29;17(6):e86944. doi: 10.7759/cureus.86944. eCollection 2025 Jun.
Background Osteoarthritis (OA) of the knee is a leading cause of disability among the elderly population, characterized by chronic pain and functional impairment. When conservative treatments fail to provide relief, total knee replacement (TKR) emerges as the gold standard surgical intervention. The effectiveness of TKR depends on appropriate patient selection, surgical technique, and structured post-operative rehabilitation. Methods A prospective cohort study was conducted at the Department of Orthopaedics, Shri B M Patil Medical College and Research Centre, Vijayapura, Karnataka, India, between April 2023 and December 2024. A total of 33 patients over the age of 50 years with grade 3 or 4 osteoarthritis were included after failure of non-operative therapy. All patients underwent TKR using the anteromedial parapatellar approach with a posterior-stabilized prosthesis. Patients were assessed pre-operatively and at post-operative day 5, 3 months, and six months using the Knee Society Score (KSS©). Statistical analysis was performed to evaluate score progression and its association with demographic variables. Results All patients had poor pre-operative KSS© (<60). By day 5 post-surgery, only 6.1% (2 out of 33) showed fair scores, while the majority remained poor. At the three-month follow-up, 72.7% (24 out of 33) of patients achieved excellent scores, and 27.2% (9 out of 33) had good scores. By six months, 100% of patients had excellent KSS©. Statistically significant associations were noted between KSS© scores at three months and both age (p=0.007) and gender (p<0.001). Complications were minimal, with only 9.1% (3 out of 33) reporting restricted range of motion and 3% (1 out of 33) experiencing superficial infection. Conclusion Primary TKR significantly improves clinical and functional outcomes in patients with osteoarthritic knees. Early post-operative recovery patterns may vary by age and gender, but outcomes equalize by six months. With proper surgical technique and rehabilitation, TKR proves to be a safe and highly effective treatment for end-stage knee osteoarthritis.
背景 膝关节骨关节炎（OA）是老年人群致残的主要原因，其特征为慢性疼痛和功能障碍。当保守治疗无法缓解症状时，全膝关节置换术（TKR）成为金标准手术干预措施。TKR的有效性取决于合适的患者选择、手术技术和结构化的术后康复。方法 2023年4月至2024年12月期间，在印度卡纳塔克邦维杰亚普拉市的什里·B·M·帕蒂尔医学院和研究中心骨科进行了一项前瞻性队列研究。33例50岁以上、非手术治疗失败的3级或4级骨关节炎患者被纳入研究。所有患者均采用前内侧髌旁入路和后稳定型假体进行TKR。术前以及术后第5天、3个月和6个月使用膝关节协会评分（KSS©）对患者进行评估。进行统计分析以评估评分进展及其与人口统计学变量的关联。结果 所有患者术前KSS©评分均较差（<60）。术后第5天，只有6.1%（33例中的2例）评分中等，而大多数患者评分仍较差。在3个月的随访中，72.7%（33例中的24例）患者获得了优秀评分，27.2%（33例中的9例）患者获得了良好评分。到6个月时，100%的患者KSS©评分优秀。在3个月时的KSS©评分与年龄（p=0.007）和性别（p<0.001）之间均存在统计学显著关联。并发症极少，只有9.1%（33例中的3例）报告活动范围受限，3%（33例中的1例）发生浅表感染。结论 初次TKR可显著改善膝骨关节炎患者的临床和功能结局。术后早期恢复模式可能因年龄和性别而异，但6个月时结局趋于一致。通过适当的手术技术和康复治疗，TKR被证明是终末期膝骨关节炎的一种安全且高效的治疗方法。
