Total knee prosthesis: Applications in our clinic and preliminary results

Abstract

23 patients (25 knees) underwent total knee prosthesis between June 1991 and October 1993. The primary pathology was degenerative ostearthritis in 21, rheumatoid arthritis in 3, and haemophilic arthropathy in 1. The types of prosthesis were Kinemax Condylar in 13, Kinematic Condylar in 9, and Zimmer MGII in 3 knees. Bone grafting was necessary in 2 cases because of the extensive medial tibial defect. Low molecular weight heparin (Fraxiparine) was used for prophylaxis of deep vein thrombosis in 18 cases. Foflow-up was 3 to 23 months (av. 8 months). The average varus deformity of 10° (range; 0-30) preoperatively was corrected to 5.2° (range; 0-11 ) of valgus. The average preoperative knee score (acc. to Hungerford) of 46 (range; 20-78) increased to 81 (range; 60-88) at the last foflow-up. Postoperatively, synovitis was detected in 2 patients and responded to medical treatment. One patient with anterior knee pain who had showed lateral subluxation of the patefla underwent lateral release 13 months after the arthroplasty. She had no pain at foflow-up. Three other patients had anterior knee pain at last foflow-up. Radiological evaluation revealed no signs of loosening. We concluded that total knee arthroplasty gives satisfactory results in the short term.

Özet

Haziran 1991 ve Ekim 1993 tarihleri arasında 23 hastanın 25 dizine total diz protezi uygulandı. Primer patoloji 21 hastada dejeneratif osteoartrit, 3 hastada romatoid artrit ve 1 hastada hemofilikartropati idi. Protez tipleri; 13 diz de Kinemax kondiler, 9 diz ve Kinematik kondiler, 3 dizde Zimmer MG 11. Aşın medial tibial defekten dolayı iki vakada kemik grefti gerekti. 18 vakada derin ven trombozu proflaksisi için düşük moleküler ağırlıklı heparin (Fraxiparine) kullanıldı. Ortalama preoperatif 10°lik (0-30) varus deformitesi, 5.2°lik (0-11) valgus olarak düzeltildi. Preoperatif ortalama 46 olan diz skoru (20-78) (Hungerford a göre), son kontrolde 81 e (60-88) yükseldi. Postoperatif 2 hastada sinovit gözlendi ve medikal tedaviye cevap verdi. Anterior diz ağrısı olan ve patella lateral subluksasyonu gösteren bir hastaya artroplastiden 13 ay sonra lateral gevşetme yapıldı. Kontrolde hastanın ağrısı yoktu. Son kontrolde 3 hastada anterior diz ağrısı görüldü. Radyolojik kontrolde hiç bir gevşeme belirtisi görülmedi. Kısa dönemde total diz artroplastisinin tatminkar sonuçlar verdiği kanısındayız