Observation on the early and mid-term clinical efficacy of primary total knee replacement by lateral parapatellar approach in the treatment of severe valgus knee deformity
Objective To retrospectively analyze the mid-term clinical efficacy and possible influencing factors of primary total knee replacement by lateral parapatellar approach in the treatment of severe valgus knee deformity.Methods From January 2019 to December 2023,17 patients with severe valgus knee deformity who underwent primary total knee arthroplasty(TKA)to treat knee osteoarthritis were studied.All surgeries were completed by senior professional surgeons.Twenty-one knees(5 males and 12 females)were treated with TKA,and the early and mid-term effects were observed.All patients were treated with a lateral parapatellar approach and a posterior cruciate ligament-retaining(CR)knee prosthesis.Results The imaging rating of all patients at the time of surgery was KL 4,and all patients were followed up.The average follow-up time was nearly 46 months.During the follow-up,no intermuscular vein thrombosis occurred except for 3 cases(incidence rate 14.29%).The average operation time during TKA was(105.71±12.80)minutes,and the average blood loss was(140.71±34.07)ml.The patients were able to walk and exercise 2 days after the operation.All patients recovered satisfactorily 1 week after the operation and were transferred to a rehabilitation hospital for subsequent rehabilitation exercise treatment.The knee valgus deformity was corrected significantly after the surgery.ROM,KSS score,WOMAC score,SF-12 score,VAS score were improved significantly.After TKA,one patient reported anterolateral knee pain that lasted for 12 weeks,which was relieved after rehabilitation exercises and point injection treatment.The remaining 20 patients reported satisfaction,with a satisfaction rate of 95.23%.A total of 15 patients reached"forgotten knee"(71.43%),with an average score of(82.95±7.53).Conclusions Total knee arthroplasty through the lateral parapatellar approach can effectively correct severe knee valgus deformity,and the mid-term efficacy is satisfactory.
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