Slight undercorrection following total knee arthroplasty results in superior clinical outcomes in varus knees

被引:290
作者
Vanlommel, Luc [1 ]
Vanlommel, Jan [1 ]
Claes, Steven [1 ]
Bellemans, Johan [1 ]
机构
[1] Univ Hosp Leuven, Pellenberg, Belgium
关键词
Total knee arthroplasty; Varus alignment; Outcome; CORONAL ALIGNMENT; REPLACEMENT; SURVIVAL;
D O I
10.1007/s00167-013-2481-4
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Restoration of correct alignment is one of the main objectives of total knee arthroplasty (TKA). However, the influence of residual malalignment on clinical and functional outcomes is currently uncertain. This study was therefore undertaken to ascertain its influence in patients undergoing TKA for varus osteoarthritis of the knee. A cohort of 132 consecutive patients (143 knees) with pre-operative varus alignment was evaluated with a mean follow-up period of 7.2 years. Based upon the post-operative alignment, patients were stratified into three groups: neutral, mild varus, and severe varus. These groups were compared with respect to clinical and functional outcomes. All patients had post-operative improvements in Knee Society Score (KSS). Knees that were left in mild varus scored significantly better for the KSS and the Western Ontario and McMaster Universities Arthritis Index, compared with knees that were corrected to neutral and knees that were left in severe varus exceeding 6A degrees. No revisions occurred in any of the groups at midterm follow-up. The results of this study contradict the conventional assumption that correction to neutral mechanical alignment leads to the best outcome following TKA. Patients with pre-operative varus had better clinical and functional outcome scores if the alignment was left in mild varus, as compared with patients with an alignment correction to neutral. Therapeutic study, Level III.
引用
收藏
页码:2325 / 2330
页数:6
相关论文
共 22 条
[11]
CORONAL ALIGNMENT AFTER TOTAL KNEE REPLACEMENT [J].
JEFFERY, RS ;
MORRIS, RW ;
DENHAM, RA .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1991, 73 (05) :709-714
[12]
Does computer navigation in total knee arthroplasty improve patient outcome at midterm follow-up? [J].
Kamat, Yogeesh D. ;
Aurakzai, Kamran M. ;
Adhikari, Ajeya R. ;
Matthews, Daniel ;
Kalairajah, Yegappan ;
Field, Richard E. .
INTERNATIONAL ORTHOPAEDICS, 2009, 33 (06) :1567-1570
[13]
No impact of severe varus deformity on clinical outcome after posterior stabilized total knee arthroplasty [J].
Lee, Bum-Sik ;
Lee, Sang-Jin ;
Kim, Jong-Min ;
Lee, Dae-Hee ;
Cha, Eun-Jong ;
Bin, Seong-Il .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2011, 19 (06) :960-966
[14]
POLYCENTRIC TOTAL KNEE ARTHROPLASTY - A 10-YEAR FOLLOW-UP-STUDY [J].
LEWALLEN, DG ;
BRYAN, RS ;
PETERSON, LFA .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1984, 66A (08) :1211-1218
[15]
Good Alignment After Total Knee Arthroplasty Leads to Faster Rehabilitation and Better Function [J].
Longstaff, Lee M. ;
Sloan, Karen ;
Stamp, Nikki ;
Bs, Matt ScaddanMb ;
Beaver, Richard .
JOURNAL OF ARTHROPLASTY, 2009, 24 (04) :570-578
[16]
Varus malalignment has no influence on clinical outcome in midterm follow-up after total knee replacement [J].
Matziolis, Georg ;
Adam, Joern ;
Perka, Carsten .
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 2010, 130 (12) :1487-1491
[17]
The influence of postoperative coronal alignment on revision surgery in total knee arthroplasty [J].
Morgan, Samer S. ;
Bonshahi, A. ;
Pradhan, N. ;
Gregory, A. ;
Gambhir, A. ;
Porter, M. L. .
INTERNATIONAL ORTHOPAEDICS, 2008, 32 (05) :639-642
[18]
Paley D, 2003, PRINCIPLES DEFORMITY, P1
[19]
Effect of Postoperative Mechanical Axis Alignment on the Fifteen-Year Survival of Modern, Cemented Total Knee Replacements [J].
Parratte, Sebastien ;
Pagnano, Mark W. ;
Trousdale, Robert T. ;
Berry, Daniel J. .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2010, 92A (12) :2143-2149
[20]
RITTER MA, 1994, CLIN ORTHOP RELAT R, P153