Total knee arthroplasty for knee varus deformity:follow-up evaluation of femorotibial angle and range of motion

Li Guang-wei; Wang Hong-jun; Sun Xiao-zhi; Chen Lin-bin; Gao Yu-liang; Bai Zhong-xu; Cheng Xin-sheng

doi:10.3969/j.issn.2095-4344.2015.09.001

Abstract：BACKGROUND:Total knee arthroplasty is difficult to perform for treating knee varus deformity, it is highly involved in several issues, such as surgical approach, intraoperative osteotomy, the order, method and extent of soft tissue release, as wel as soft tissue balance. There are a lot of controversies for this treatment. <br> OBJECTIVE:To observe the femorotibial angle and range of knee joint motion of adults patients with knee varus deformity during 1-year fol ow-up after total knee arthroplasty. <br> METHODS:A total of 31 patients (35 knees) with knee varus deformity were treated with posterior stabilized prosthesis replacement from June 2006 to June 2013. Using patel ar medial approach, the correct osteotomy and selective soft tissue release were performed to restore normal knee alignment and soft tissue balance. Posterior stabilized prosthesis in total knee arthroplasty was applied to achieve knee stability. Postoperative targeted rehabilitation training was also fol owed. The femorotibial angle was measured before and after surgery. The range of knee joint motion was determined during postoperative fol ow-up. Patients were evaluated with the Hospital for Special Surgery (HSS) score and the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. <br> RESULTS AND CONCLUSION:Al patients were fol owed up for 12-96 months through out-patient clinic. The femorotibial angle was corrected from preoperative varus 17.69° (5°-30°) to postoperative 5.66° (2°-8°);the range of knee joint motion was improved from preoperative 74.29° (60°-95°) to 119.46° (105°-130°);the HSS score increased from preoperative 26.60 points (14-42 points) to postoperative 89.03 points (82-95 points);and the WOMAC score increased from preoperative 42.83 points (28-54 points) to postoperative 90.17 points (85-95 points). Statistical analysis results showed that, total knee arthroplasty significantly improved the femorotibial angle, range of knee joint motion, HSS score and WOMAC score in al involved patients (P<0.01). Postoperative X-ray films showed no evidence of periprosthetic lucent zone, normal knee alignment, no patel a baja and fracture. Total knee arthroplasty surgery can correct knee varus deformity, significantly improve the functions, and achieve satisfactory results at 1 year after surgery.