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KMID : 0352119890050010037
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Journal of Kyung Hee University
1989 Volume.5 No. 1 p.37 ~ p.42
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Clinical Results of Total Knee Arthroplasy
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Bae, Dae Kyung/배대경
Lee, Song/Ahn, Jae Young/이송/안재용
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Abstract
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Eighty six total knee replacements in sixty patients were performed during the period from August 1982 to August 1986. The first consecutive 43 knees in 30 patients were prospectively reviewed with a follow-up period of more than two years.
The average preoperative knee motion was 91% The average postoperative knee motion improved to 110.2. The improvements of pain and flexion contracture were significant. Hospital for Special Surgery knee scores improved from 39.5 to 87. Major complications included one deep infection and two knees of peroneal nerve palsy.
In total knee replacement special considerations were needed for the management of problem knee. For successful results, management must be considered in relation to individual patients and specific prosthesis.
The correct tightness in flexion was difficult to obtain after an extensive ligament release for the correction of severe deformity. In patients with severe flexion contracture and angular deformity, posterior cruciate sacrificing design seems to be more useful, especially if bone cuts were needed before soft tissue release.
A patient who had severe knee range of motion restriction following total knee replacement was treated by the percutaneous release of adhesions under arthroscopic visualization. The source of pathology was intra-articular adhesion formation. Intra-articular release of adhesions under arthroscopic control was assumed very useful.
Late hematogenous infection developed after total knee replacement in Charcot knee was treated with debridement, suction drainage and systemic antibiotics. In Charcot knee with :neurological dysfunction, posterior dislocation of the prosthesis developed about seven months after infection. Brace was applied to prevent redislocation.
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