Outcome of total knee arthroplasty in patients with poliomyelitis
| Autor: | Pramod Achan, Rej Bhumbra, Sebastian Dawson-Bowling, Manoj Ramachandran, Sammy A. Hanna, Anoop Prasad, Richard Donovan, Steven Millington |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
musculoskeletal diseases
Genu recurvatum 030222 orthopedics medicine.medical_specialty Ligamentous laxity biology business.industry Total knee arthroplasty Periprosthetic musculoskeletal system medicine.disease biology.organism_classification Poliomyelitis Surgery 03 medical and health sciences Valgus 0302 clinical medicine medicine Orthopedics and Sports Medicine 030212 general & internal medicine Implant Tibia business |
| Zdroj: | EFORT Open Reviews. 3:358-362 |
| ISSN: | 2058-5241 2396-7544 |
| DOI: | 10.1302/2058-5241.3.170028 |
| Popis: | Total knee arthroplasty (TKA) in patients affected by poliomyelitis is technically challenging owing to abnormal anatomical features including articular and metaphyseal angular deformities, external rotation of the tibia, excessive valgus alignment, bone loss, narrowness of the femoral and tibial canals, impaired quadriceps strength, flexion contractures, genu recurvatum and ligamentous laxity. Little information is available regarding the results and complications of TKA in this challenging group of patients. We carried out a systematic review of the literature to determine the functional outcome, complications and revision rates of TKA in patients with poliomyelitis-affected knees. Six studies including 82 knees met the inclusion criteria and were reviewed. The mean patient age was 63 years (45 to 85) and follow-up was 5.5 years (0.5 to 13). All studies reported significant improvement in knee function following TKA. There were six failures requiring revision surgery in 82 cases (7%) occurring at a mean of 6.2 years (0.4 to 12). The reasons for revision surgery were aseptic loosening (17%, n=1), infection (33%, n=2), periprosthetic fracture (17%, n=1) and instability (33%, n=2). Thirty-six knees had a degree of recurvatum pre-operatively (44%), which was in the range of 5° to 30°. Ten of these knees (28%) developed recurrent recurvatum post-operatively. The findings support the use of TKA in patients with poliomyelitis-affected knees. The post-operative functional outcome is similar to other patients; however, the revision rate is higher. Quadriceps muscle power appears to be an important prognostic factor for functional outcome and the use of constrained implant designs is recommended in the presence of less than antigravity quadriceps strength. Cite this article: EFORT Open Rev 2018;3:358-362. DOI: 10.1302/2058-5241.3.170028 |
| Databáze: | OpenAIRE |
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