Extension First Osteotomy in Total Knee Athroplasty

LIU Jin-bang; NIU Yun-feng; LI Guang-xian

Abstract：Objective To explore the clinical effect of the extension first osteotomy in the process of total knee athroplas-ty. Methods A retrospective study was performed for 39 cases. There were 36 cases of osteoarthritis,3 cases of rheumatoid ar-hritis. The LDK JOINT prosthesis were used for total knee arthroplasty. The distal femoral osteotomy was performed firstly ac-cording to the valgus angle measured preoperatively,and then the tibial plateau osteotmy was performed based on the tibial ex-tramedullary positioning device. Patella was not routine replacement. Last we performed oblique osteotomy anterior and posterior to the distal femur( contained intercondylar osteotomy). The operation time,postoperative drainage volume,range of motion of knee joint as well as Hospital for Special Surgery knee scores before replacement and 2 and 6 weeks after replacement were re-corded and statistically analyzed. Results All the 39 patients were followed up for 3 to 14 months. The average operation time was(118. 3±30. 4)minutes;the postoperative drainage volume was(272. 7±106. 1)mL. The range of motion of knee joint and Hospital for Special Surgery knee scores 2 and 6 weeks after replacement were improved compared with those before re-placement(P<0. 05). There was no infection,no prosthesis rejection. Conclusion That the improved osteotomy can make the bone cutting more accurate,and reduce the chance and risk of osteotomy repeatedly. This method has the advantages of simple operation,shortening the operation time,reducing the intraoperative blood loss,protecting the surrounding soft tissue safely,en-suring the postoperative totally extend knee and better limb alignment.