Affection Of Knee Flexion Angle In Total Knee Arthroplasty By Femoral Componet Flexion

Objective:To evaluate Prosthetic and operative modifications in totalknee arthroplasty (TKA) which have been proposed to maximisepost-operative knee flexion as it is essential in routine functionalactivities.Methods: We performed a randomised controlled trial to compare clinicaloutcomes，the objects come from the patients who have had an operationof primary posterior-substituting(PS) TKA for osteoarthritis in theDivision2of orthopedics of Fujian Provincial Hospital,and the time rangecomes from August2011to February2012.Body mass index(BMI) of all onesare less than30kg/m2.52patients(56knees)have been chosen.29patients(33knees) have been operate with the femoral component implantedin a neutral position in the sagittal plane（NON-FCF Group),and23patients(23knees) in flexion (FCF Group). NON-FCF group:6Malepatients(6knees),23female patients(27knees)，average age63.75yearsold（51～80）,BMI22.80kg/m2(19.15～28.53),preoperative HSS55.88（41～69）；preoperative angle of greatest flexion88.47°（69°～116°）;FCF-group:7Male patients(7knees),16female patients(16knees)，averageage61.36years old（50～75）,BMI23.71kg/m2(18.16～29.57),preoperativeHSS56.29（39～68）；preoperative angle of greatest flexion90.6°（70°～113°）.The operative time,blood loss and transfusion,postoperativeangle of greatest flexion,postoperative HSS and The incidences ofcomplications et al have been observed.The two groups can been comparedfor the reason that there is no obvious difference in sex ratio, age,disease and preoperative condition.Results:1.All the patients have complete the1year follow-up,with the stage Ⅰincision healed. No patient required a revision surgery till lastfollow-up.2.FCF group：the operative time:110.17min(81～140min)；theblood loss:400.47ml(311～560ml)；the transfusion:3.37u(2～6u).NON-FCFgroup: the operative time:108.80min(80～138min); the bloodloss:387.67ml(296～536ml)；the transfusion:2.87u(0～6u).the differencein the operative time、the blood loss and transfusion et al have nostatistical significance(P>0.05).2. Significant differences were foundbetween the groups in postoperative knee flexion(FCF Group：126.03°（112°～138°）；NON-FCF Group：120.23°（100°～135°），P<0.05）。3.The lastfollow-up HSS，FCF Group：90.83（78～99），NON-FCF Group：88.03（77～99），the difference beening compared with the preoperative HSS has obviousstatistical significance,but no one when beening compared in thepostoperative HSS of the two groups.4. Significant differences were foundbetween the two groups in knee flexion contracture,but not in the imagingevaluation.Conclusion: Flexing the femoral implant in this posterior-substitutingTKA system provided a significant difference in knee flexion compared toa neutral position.But the Long-term clinical efficacy and postoperativecomplications still need further follow-up.