بررسي نتايج درماني جراحي تعويض مفصل زانو با پروتز كامل در بيماران مبتلا به آرتريت دژنراتيو مفصل زانو

Evaluation of the Results of Operation of T.K.A. Patients with Degenerative Arthritis of the knee

Introduction: total knee replacement in elderly patients has been well documented as effective for relief of pain, correction of deformity, and improvement of function. In this present study, to evaluate the five years functional outcome of knee replacements in old patients, with special attention to activities in which the patients participated. Method: In patient with total knee arthroplasties performed between 1998 and 2002 inpatients who were 60 to 79 years old to determine the appropriate management for patients who have severe osteoarthrosis. 31 knee replacements were performed in 27 patients. Ten knees (ten patients) were lost to follow-up. Follow-up data for the remaining 21 knees in 17 were used to perform the survivorship analysis. All of the operations were performed with the use of cementing techniques. Twenty-one unrevised knees were available for clinical evaluation with the scoring Knee Society at an average of five years postoperatively. The activity levels of the patients were assessed with the activity score of Tegner and Lysholm. Radiographs were examined for evidence of loosening of the component. Result: According to the system of the Knee Society, the average knee score was 94 points and the average functional score was 89 points. Nineteen knees (90 per cent) had good or excellent function. The average activity score improved from 1.3 points (range, 0 to 4 points) preoperatively to 3.5 points (range, I to 6 points) at the latest follow-up examination. All but two patients had improvement in the activity score postoperatively Conclusion: Researchers consider arthroplasty with cementing total knee prosthesis to be effective operative treatment with durable results for osteoarthrosis in old patients when other, less invasive measures have failed. Within the average 2.5 year follow-up interval of this study, polyethylene wear, osteolysis, and loosening of the prosthesis were not major problems for these old patients, although it is possible that this observation could change with an even longer duration of follow-up.