| Objective: To analyze the relationship between coronal inclination angle of tibial prosthesis and clinical outcome as well as the situation of postoperative numbness of lateral knee of total knee arthroplasty.Methods: We collected the data of patients who underwent primary TKA(Total Knee Arthroplasty)from September, 2002 to May, 2010 in The First Affiliated Hospital of Dalian Medical University,a total of 30 patients who had complete medical records were followed up, including 4 males with 4 knees and 26 females with 34 knees.There were total 38 knees(among which, 20 patients with unilateral knee arthroplasty, 9 cases underwent bilateral knees arthroplasty), the mean age was(75.6±5.7) years;According to preoperative diagnosis, 29 cases with 37 knees were knee osteoarthritis, one case with one knee was rheumatoid arthritis, the time after the last surgery was 5-13 years,average time was(93.3±27.7 months). We told these patients to our hospital for test with X-ray weight-bearing long-leg anterioposterior film and anterioposterior and lateral film of knee joint in our hospital, and attend the clinic to have a physical examination and at the same time fill out KSS(Knee Society Score) Evaluation Form,2000 IKDC Subjective Knee Evaluation Form.Meanwhile, we recorded weather the patient had the numbness of lateral knee. The TCA( tibial component alignment)was measured. They were divided into three groups according to TCA,Group A(valgus degrees<3°, 87.00°< TCA<90.00°), Group B(varus degrees <3°,90.00°≤ TCA< 93.00°) and Group C(varus degrees ≥3°, TCA ≥93.00°). The differences among ROM(the range of motion), KSS clinical scores, and function scores of patients in each group were analyzed and compared. In addition, they were divided into two groups according to TKA postoperative time, named Group M(postoperative time≥7years) and Group N(postoperative time <7 years), the statistics of difference of skin numb between two groups was conducted.Results: The mean age of Group A, Group B and Group C were 74.17±5.42 years,75.70±6.16 years, 75.00±3.08 years, mean BMI(body mass index) was 27.53±1.60,28.51±4.20, 27.70±4.18; Preoperative ROMs of Group A, Group B and Group C were93.33°± 20.66°, 100.93°±20.99°, 95.00±12.25°, preoperative KSS clinical scores and function scores of knee joint were(52.00±7.04, 45.83±9.17),(54.63±7.17, 49.44±6.98),(53.20±3.42, 48.0±9.08). There were no statistical differences of preoperative age, BMI,KSS clinical score and function score, preoperative flexion contracture degree,ROM and postoperative time among three groups(P> 0.05). Postoperative the ROMs of group A, Group B and group C were: 105.0°±15.49°, 110.0°±10.00°, 92.00°±11.51°respectively, there was no statistical difference between Group A&B and Group A&C,(P>0.05), however, there was statistical difference between Group B &C(P <0.01).Postoperative the KSS clinical scores of Group A, Group B and Group C were91.83±2.32, 91.59±8.81, 88.80±6.38 respectively, postoperative KSS function scores were: 77.50±20.92, 74.07±21.22, 63.00±17.18 respectively. There were not statistical differences of KSS clinical score and function score among the three groups(P> 0.05).Through subjective narration and objective examination, the statistics of numbness of lateral knee of patients was conducted, there were 5 cases in Group M, accounting for25.0% of the group; there were 12 cases in Group N, accounting for 66.7% of the group,a chi-square test was conducted to calculate and analyze the exact test of Fisher, P =0.021, which has statistical difference.Conclusion: 1. There is no significant difference in postoperative ROM and KSS score between the patients whose TCA are 90±3°; 2. For these cases in this study, thepostoperative ROM of Group C is less than Group B, but there was no significant difference of KSS score; 3. Among some patients, the numbness of lateral knee could alleviat or disappear after TKA. |
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