DOI: https://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20221621
Published: 2022-06-24

Functional outcome of mild and moderate residual varus in posterior stabilized total knee arthroplasty in primary osteoarthritis knee: a prospective study

Bharath M. C., T. H. Prakashappa, Madhusudan B., Nithin S. M.

Abstract


Background: Total knee arthroplasty (TKA) is one of the most commonly done orthopaedic surgical procedures for treating severe arthritis of the knee joint caused by osteoarthritis or inflammatory arthritis. The current clinical investigation, done at the Sanjay Gandhi Institute of Trauma and Orthopaedics in Bengaluru, provided the short-term functional result of mild and moderate residual varus in posterior stabilized TKA. The aim was to evaluate the efficacy of mild and moderate residual varus in total knee replacement for primary OA knee in terms of pain relief, range of motion and stability of the joint.

Methods: 30 total knee replacements were performed. All patients were examined pre- and post-operatively using the knee society clinical and functional score. The average pre-op KSS knee score was 38.7, with a functional score of 23.3. The most common reason for TKR was osteoarthritis. The follow-up time ranged from 6 to 12 months.

Results: By the knee society clinical, functional score method, 96.6% of our patients received an outstanding assessment after scoring 80 points or higher. The mean post-operative KSS knee score is 86.57, and the knee society functional score is 92. 92% of patients had little/no pain after surgery, and walking ability increased and was unlimited in 80% of patients.

Conclusions: After a short term follow up of 1 year in a research population of 30 with pre-operative osteo arthritis of the knee, with post-operative mild to moderate varus alignment showed better clinical results.


Keywords


Osteoarthritis knee, Total knee arthroplasty, Residual varus

Full Text:

PDF

References


Bijlsma JW, Berenbaum F, Lafeber FP. Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011;377:2115-26.

Choong PF, Dowsey MM, Stoney JD. Does accurate anatomical allignment result in better fucntion and quality of life? comparing conventional and computer based TKA. J Arthroplasty. 2009;24(04):560-9.

William MM. Arthroplasty of the knee, Campbell operative orthopedics, 12th ed. Philadelphia; Elsevier; 2013;7(1):367.

Berernd ME, Ritter MA, Meding JB, Faris PM, Keating EM, Redelman R, Davis KE. Tibial component failure mechanism in total knee arthroplasty. Clin Orthop Relat Res. 2004;428:26-34.

Lima DD, Chen PC, Colwell CW. Polyetylene contact stress ,articular congruity,and knee alignment. Clin Orthop Relat Res. 2001;392:232-8.

Jones CA, Voaklander DC, Johnston DW, Suarez-Almazor ME. Health related quality of life outcomes after total hip and knee arthroplasties in a community based population. J Rheumatol. 2000;27(07):1745-52.

Nishida K,Matsumoto T, Takayama K. Remaining mild varus limb alignment leads to better clinicl outcome in total knee arthroplasty for varus osteoarthritis. Knee Surg Sports Tramatol Arthrosc. 2017;25(11):3488-94.

Vanlommel L, Vanlommel J, Claes S, Bellamans J. Slight under correction following total knee arthroplasty results in superior clinical outcomes in varus knees. Knee Surg Sports Traumatol Arthrosc. 2013;21(10):2325-30.

Meding JB, Fish MD, Bernerd ME, Keating EM. Predicting patellar failure after total knee arthroplasty. Clin Orthop Relat Res. 2008:466(11):2769-74.

Howell SM, Shelton TJ, Hull ML. Implant survival and function ten years after kinematically alignment total knee arthroplasty. J Arthroplasty. 2018;33(12): 3678-84.

Hanusch B,Lou TN, Warriner G, Hui A, Gregg P. Functional outcome of PFC Sigma fixed and rotating-platform total knee arthroplasty. Iowa Orthop J. 2010; 34:349.

Baken PN, van der Meulen JH, Lewsey J, Gregg PJ. National joint registry for england and wales. the role of pain and function in determining patient satisfaction after total knee replacement: data from the national joint registry for England and Wales. J Bone Joint Surg. 2007;89-B:893-900.

Seon JK, Song EK, Park SJ, Lee DS. The use of navigation to obtain rectangular flexion and extension gaps during primary total knee arthroplasty and midterm clinical results. J Arthroplasty. 2011;26(4): 582-90.