An effect analysis of semi-restrictive prosthesis in Charcot arthropathy of the knee
DENG Li-qing
KANG Peng-de
PEI Fu-xing
SHEN Bin
YANG Jing
ZHOU Zong-ke
TAN Zhen
XIE Xiao-wei
Abstract：Objective To evaluate the application and clinical results of semi-restrictive prosthesis in total knee arthroplasty ( TKA ) for Charcot arthropathy of the knee.Methods Twelve patients ( 5 males and 7 females, 12 knees ) with Charcot arthropathy of the knee in our hospital from July 2003 to June 2013 were performed TKA and clinical results were reviewed and analyzed. The mean age was 48 years ( range: 30-70 years ). Semi-restrictive prostheses were used in all knees, including 7 knees with extension rod. Patients were followed up postoperatively at 1 month, 3 months, 6 months, 12 months, and annually thereafter. The mean follow-up period was 6.5 years ( range: 14 months-11 years ). Anteroposterior and lateral X-ray was taken in each follow-up. Hospital for Special Surgery ( HSS ), American Knee Society Score ( KSS ), knee range of motion ( ROM ), stability, and prosthesis location were evaluated.Results One deep infection had developed with acute hematogenous pattern at 2 years and was successfully treated with 2-stage revision. X-ray iflm showed good recovery positions of the prostheses and lower limb force lines in other patients. Postoperatively, pain completely disappeared, knee joint deformity was corrected, stability and functions were good, no prosthetic loosening or deep venous thrombosis ( DVT ) was developed. The mean Hospital for Special Surgery ( HSS ) knee score increased from 51.5 points ( range: 32-72 points ) before surgery to 87.7 points ( range: 82-96 points ) at the ifnal follow-up with statistical signiifcance (P<0.01 ). The mean clinical Knee Society Score ( KSS ) was 87.5 points ( range: 80-95 points ) postoperatively and 57.9 points ( range: 35-70 points ) preoperatively withstatistical significance (P<0.01 ). The mean functional Knee Society Score ( KSS ) was 86.9 points ( range: 80-95 points ) postoperatively and 56.8 points ( range: 30-70 points ) preoperatively with statistical signiifcance (P<0.01 ). The preoperative range of motion ( ROM ) averaged 96.5° ( range: 85°-110° ) preoperatively and 115° ( range: 110°-130° ) postoperatively with statistical signiifcance (P<0.01 ). All patients were satisifed with the clinical results at the lastest follow-up.Conclusions Semi-restrictive prosthesis in TKA is effective for Charcot arthropathy of knee. Patients of Charcot arthropathy can receive good midterm results by proper soft tissue release, accurate osteotomy, suitable repair of bone defects, correct prosthesis selection, and postoperative rehabilitation. However, long-term effect remains to be further investigated.
Keywords：Knee prosthesisKnee jointCharcot arthropathySemi-restrictive prosthesis
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 574-578 )