Clinical study of one-stage total knee replacement for knee varus osteoarthritis with lateral tibial articular deformities
Objective To investigate the clinical efficacy of one-stage total knee arthroplasty on knee varus osteoarthritis of tibial extra-articular deformities.Methods A total of 100 patients with knee varus osteoarthritis treated in the First Affiliated Hospital of Xinxiang Medical University from January 2019 to January 2022 were selected.According to whether the medial angle of the proximal tibia was normal,they were divided into two groups.The 39 patients combined with tibial extraarticular deformities were in group A,and the 61 patients without tibial extraarticular deformity were in group B.Both groups were treated with one-stage total knee replacement.The surgical indexes,lower limb force line and knee joint function were compared between the two groups.Results There was no significant difference in osteotomy thickness and operation time between group A and group B(P＞0.05).The thickness of gasket,the proportion of bone amputation with 5° lateral rotation of posterior femoral condyle and the use rate of restricted prosthesis in group B were lower than those in group A,with significant differences(P＜0.05).The proximal medial tibial angle(MPTA)and hip knee ankle angle(HKA)of group A and group B were higher than those before surgery,and the varus angle was lower than that before surgery,the differences were significant(P＜0.05).There was no significant difference in MPTA,HKA and varus angle between the two groups at 1 year after surgery(P＞0.05).There was no significant difference in the rate of force line recovery 1 year after operation between the two groups(P＞0.05).The KSS score of group A and group B 1 year after surgery was higher than those before surgery,and the VAS score was lower than that before surgery,the differences were significant(P＜0.05).There was no significant difference in KSS score and VAS score 1 year after surgery between the two groups(P＞0.05).Conclusions One-stage total knee replacement can effectively improve the lower limb force line and knee function in patients with knee varus osteoarthritis.Combined with tibial extra-articular deformity will increase the difficulty of surgery,with high use of restrictive prosthesis,and thicker thickness of spacer.
One-stage total knee replacementTibial extraarticular deformityKnee varus osteoarthritis
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