Effect Of Individualized Valgus Osteotomy On Total Knee Arthroplasty

Objective: To explore the effect of individualized valgus osteotomy on total knee arthroplasty.Methods: This study included data from 70 patients who met the KOA criteria for the initial TKA treatment in our department of arthritis from August 2017 to December 2018.They were randomly divided into case group(group A,35)and control group(group B,35).Group A had 5 males(5 knees)and 30 females(38 knees).The average age of males was 68.8 years(range 62 to 79 years)and females were 66.9 years old(range 53 to 78 years old).Group B consisted of 3 males(3 knees)and 32 females(36 knees).The average age of men was 60 years(range 54 to 69 years)and females were 65.9 years(range 51 to 82 years).Patients in group A underwent individualized total knee arthroplasty of KPV distal femoral incision based on preoperative full-length standing radiographs;group B underwent fixed 6° valgus total knee arthroplasty.The two groups of patients were evaluated for limb alignment before and after surgery using full-length standing radiographs.The HKA angles of group A and group B were calculated and recorded in the coronal plane compared with the target(180 ± 3 °)before and after surgery.The preoperative and postoperative HSS scores,VAS scores,and knee mobility(ROM)were calculated and compared..Results: All 70 patients were followed up and their TKA data were analyzed.Mean ages of group A and group B(66.1 and 65.2 years,P=0.648),body mass index(26.1 and 25.0 kg / m 2,P=0.169)and gender(85.7% and 91.4% of women,P=0.707),group A There was no significant difference between the three parameters and the B group,which was comparable(Table 1).The mean VAS scores of group A and group B before surgery were similar(6.0 points and 6.3 points,P=0.310).At 1 month follow-up,the mean of group A was 2.2 points,and that of group B was 2.6 points,P=0.009.At 3 months,the average of group A was 1.2 points,and that of group B was 1.5 points,P=0.001.The average of group A at 6 months It was 0.3 points,and the B group was 0.6 points,P=0.004.There was a statistically significant difference between group A and group B(see Table 2).The mean HSS scores of group A and group B were similar before surgery(44.5 points and 48.0 points,P=0.099).At 1 month follow-up,the average of group A was 80.9 points,and that of group B was 77.8 points,P=0.008.The average of group A was 91.5 points at 3 months,and that of group B was 89.1 points,P=0.015.The average of group A at 6 months It was 95.8 points,and the B group was 94.0 points,P=0.010.There was a statistically significant difference between group A and group B(see Table 3).The mean values of ROM in group A and group B before surgery were similar(99.0° and 98.0°,P=0.778).At 1 month follow-up,the average was 113.1° in group A,104.8° in group B,and P=0.002.The average of group A was 126.7° at 3 months,and that of group B was 122.4°,P=0.010.Group A at 6 months.The average was 128.3°,and the B group was 125.1°,P=0.037.There was a statistically significant difference between group A and group B(see Table 4).The mean values of HKA angles in group A and group B before surgery were similar(168.8° and 168.2°),and there was no significant difference between group A and group B(P=0.516,Table 5).The mean postoperative HKA angle was(178.4±1.5°)in group A and(177.3±1.9°)in group B.Compared with target(180±3°)in group C,group A was closer to the target value(P=0.009).Table 5),compared with group B,the accuracy of mechanical axis alignment of group A after surgery was better than that of group B,with statistical differences.Conclusion: According to the pre-and post-operative full-length radiographs of KPV,individualized osteotomy for distal femoral resection can achieve accurate osteotomy,improve the accuracy of postoperative lower limb line alignment and repair limb alignment,and early and faster recovery.Knee function.In terms of clinical relevance,it is recommended to perform individualized osteotomy according to the measured KPV in total knee arthroplasty in order to achieve the expected postoperative lower limb line alignment and rapid recovery of the knee function of the early limb.