The early clinical outcomes of condylar-constrained prosthesis combined with a metal block for the treatment of severe knee osteoarthritis with AORI type Ⅱ tibial defects
Objective The early clinical outcomes using condylar-constrained prosthesis combined with a metal block for the treatment of severe knee osteoarthritis with AORI type Ⅱ tibial defects were investigated.Methods A retrospective analysis was conducted on 49 patients(60 knees)with severe knee osteoarthritis and AORI type Ⅱtibial defects.All underwent total knee arthroplasty(TKA)with condylar-constrained prosthesis and metal block from January 2018 to December 2019 in our hospital.There were 16 males and 33 females,with an age range of 48 to 81 years(mean:64.06±6.12 years).The average operation time,blood loss,and surgical complications were recorded.Knee joint range of motion(ROM)was measured before surgery and at the last follow-up.Hospital for Special Surgery(HSS)score and Knee Society score(KSS)were evaluated.Results The average operation time was 100.9 minutes,incision length 14.5 cm,intraoperative blood loss 194.8 ml,and postoperative drainage 237.1 ml.After surgery,the average proximal medial tibial angle increased from 80.0° to 87.3°,and the average femorotibial angle decreased from 186.0° to 175.0°.The average follow-up was 49.1 months with no vascular and nerve injuries,periprosthetic fractures,osteolysis,prosthesis loosening,or joint instability occurred during the follow-up.Only one patient developed periprosthetic infection at 6 months postoperatively and underwent revision treatment,resulting in a prosthetic survival rate of 98.3%.At the last follow-up,the knee joint flexion-extension range of motion increased from(62.80±24.09)° preoperatively to(109.25±6.16)°;the HSS score increased from(36.03±12.20)to(89.02±9.58);the KSS clinical score increased from(35.55±11.41)to(88.12±8.97),and the KSS functional score increased from(36.67±11.71)to(86.67±8.57);all were with statistical significance(P<0.05).Conclusions The combination of constrained condylar prosthesis and metal block augmentation is an effective method to reconstruct bone defects in knee osteoarthritis patients with AORI Ⅱ tibial defects.This method can restore the joint line level,balance flexion-extension gap,enhance joint stability,and improve the quality of life and joint function of patients,with satisfactory clinical efficacy and early survival rate.
Arthroplasty,replacement,kneeProstheses and implantsBone defect
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