[Midterm results of total knee arthroplasty in degenerative knee joint diseases with severe deformity].
OBJECTIVE
We evaluated the midterm results of total knee arthroplasty in degenerative knee joint diseases with severe deformity.


METHODS
Total knee arthroplasty was performed in 125 knees of 86 patients (75 women, 11 men; mean age 69 years; range 39 to 85 years) with degenerative knee joint diseases accompanied by severe deformity. Almost all the patients had osteoarthritis (100 knees, 80%) or rheumatoid arthritis (22 knees, 17.6%). Thirty-nine patients with bilateral involvement underwent single-stage (n=20) or two-stage (n=19) surgery. During surgery, the posterior cruciate ligament was sacrificed in 108 knees and retained in 17 knees. Pre- and postoperative assessments were made according to the Knee Society clinical scoring system. The mean follow-up was 53 months (range 24 to 96 months).


RESULTS
The results were excellent or good in 80.2% of the knees. Nine knees (7.2%) required revision surgery, of which preoperative diagnosis was rheumatoid arthritis in five. The reasons for revision were infection-related problems (n=5), aseptic loosening (n=3), and periprosthetic fracture (n=1). Compared with preoperative values, the mean knee score increased by 60.9 (from 26.2 to 87.1), and the mean functional score increased by 42.6 (from 33.2 to 75.8) (p<0.05), with a mean range of knee joint motion of 93.2 degrees . The mean preoperative and postoperative alignments were 17.8 degrees of varus and 4.1 degrees of valgus (range 0 degrees to 6 degrees ), respectively. The number of knees with a flexion contracture decreased from 68 (mean 28.8 degrees ) to 8 (mean 8.4 degrees ), all of which had a flexion contracture angle below 10 degrees .


CONCLUSIONS
Total knee arthroplasty performed in degenerative knee joint diseases with severe deformity significantly improves patients' complaints and functional results.
Güçlü
Berk
B
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Ufuk University, Ankara, Turkey. gucluberk@yahoo.com
Güzel
Bahaddin
B
Başarir
Kerem
K
Erdemli
Bülent
B
Cetin
Ilker
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D016916:Joint Deformities, Acquired / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D017063:Outcome Assessment, Health Care; D011859:Radiography; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014421:Turkey