- 期刊
Total Knee Arthroplasty using a Lateral Parapatellar Approach for Valgus Knee
並列摘要
Purpose: Total knee arthroplasty (TKA) in patients with valgus deformities can be surgically challenging (compared to surgery for repair of the more common varus deformed knee) as there are often complex bony deficiencies with soft tissue contracture in the lateral side. The purpose of this retrospective study was to highlight the surgical technique of TKA via a lateral parapatellar approach for valgus deformed knee and present the associated clinical outcomes. Methods: Forty-six knees in 42 patients with valgus deformed knees underwent TKA via the lateral parapatellar approach. Nine tibial tubercle osteotomies were performed. Results: Follow-up duration averaged 30 months (range: 24-84 months). The mean tibiofemoral angle was 17.0±7.6º valgus (range: 2º-36º) preoperatively and 6.8±2.6º valgus (range: 0º-13º) postoperatively. Mean flexion contracture was 9.9±7.7º (range: 0º-30º) preoperatively. The postoperative flexion contracture was 0º in 78.3% of knees, 5º in 6.5% of knees, and 10º in 15.2% of knees. The mean range of motion was 95.0±17.2º (range: 70º-135º) preoperatively and 115.0±12.3º (range: 85º-130º) postoperatively. The average preoperative HSS knee score was 55.0±12.9 (range: 35-80), while the postoperative score was 87.0±8.3 (range: 63-97). The postoperative mechanical axis passed through the central third of the knee joint in 95.7% of knees. Patellar tracking was neutral in 91.3% of knees. There were two complications in this study: one was transient common peroneal nerve palsy with spontaneous recovery within three months post-surgery, the other was wound dehiscence with superficial skin necrosis. This was treated with debridement and STSG and healed uneventfully. There was one case where a constrained prosthesis was required due to a mismatch of the flexion-extension gap and the attenuated medial collateral ligament.
延伸閱讀
- Harman, M. K., Bonin, S. J., Leslie, C. J., Banks, S. A., & Hodge, W. A. (2014). Total Knee Arthroplasty Designed to Accommodate the Presence or Absence of the Posterior Cruciate Ligament. Advances in Orthopedics, (2014), 31-38. https://doi.org/10.1155/2014/178156
- Chou, P. H., Chen, T. H., Lee, K. S., Chen, C. F., Huang, C. K., Su, Y. P., Chiang, C. C., & Chen, W. M. (2006). Total Knee Arthroplasty for Knee Arthritis with Valgus Deformity through the Midvastus Approach. Journal of Orthopaedic Surgery Taiwan, 23(3), 91-97. https://www.airitilibrary.com/Article/Detail?DocID=10116923-200609-23-3-91-97-a
- 黎文龍、黃俊雄、劉建緯（2004）。Evaluation of the Three-Peg Patellar Component in Total Knee Arthroplasty。技術學刊，19(1)，55-61。https://doi.org/10.29507/JT.200403.0007
- Lin, L. C. (2001). The Comparison of Sequential Bilateral and Unilateral Total Knee Arthroplasty. Journal of Orthopaedic Surgery Taiwan, 18(2), 57-62. https://www.airitilibrary.com/Article/Detail?DocID=10116923-200106-18-2-57-62-a
- Yassin, M., Garti, A., Weissbrot, M., Ashkenazi, U., Khatib, M., & Robinson, D. (2016). Treating Anterior Knee Pain in the Post-Arthroplasty Patient by Isolated Patellar Resurfacing (IPR). Journal of Orthopaedics and Trauma, (6), 2-5. https://doi.org/10.4303/jot/235915