医学
骨关节炎
冠状面
膝关节
射线照相术
骨科手术
关节置换术
核医学
外科
口腔正畸科
放射科
病理
替代医学
作者
Elliot Sappey‐Marinier,Cécile Batailler,John Swan,Axel Schmidt,Laurence Chèze,Samuel J. MacDessi,Elvire Servıen,Sébastien Lustıg
标识
DOI:10.1007/s00167-021-06674-w
摘要
PURPOSE: In total knee arthroplasty (TKA), knee phenotypes including joint line obliquity are of interest regarding surgical realignment strategies. The hypothesis of this study is that better clinical results, including decreased postoperative knee pain, will be observed for patients with a restored knee phenotype. METHODS: test. Significance was set at p < 0.05. RESULTS: A third of patients (33.4%) had constitutional knee varus with apex distal JLO. 63.5% of patients had preoperative apex distal JLO. Postoperatively, 57.8% of patients had a neutral HKA (- 2° to 2°) and a neutral JLO (- 3° and 3°), with only 18% of patients with restored constitutional knee phenotype. Of these patients, statistically less postoperative pain was observed in patients where apex distal JLO was restored compared to non-restored apex distal JLO (pain score 46.7 vs. 44.6; p = 0.02) without clinical relevance. Other categories of restored JLO or arithmetic HKA angle were not associated with improved outcomes. CONCLUSION: This study showed that performing mechanical alignment for primary TKA resulted in most cases in a change of the preoperative knee phenotype. These results emphasize the relevance of considering joint line obliquity to better understand preoperative knee deformity and better restore knee phenotypes with a more personalized realignment strategy to potentially improve TKA postoperative results. LEVEL OF EVIDENCE: III.
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