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Category: Volume 08 Issue 05 May 2020
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Title: A Study of Functional Outcome of Advanced Osteoarthritis Knee Treated with Total Knee Arthroplasty

Authors: Dr Jithin Jose, Dr Balagopalan K, Dr Sabarisree M

 DOI: https://dx.doi.org/10.18535/jmscr/v8i5.90

Abstract

 

Introduction: Osteoarthritis is thought to be the most prevalent chronic joint disease. The incidence of arthritis is increasing because of ageing population and rise of obesity. Total knee arthroplasty is now the reliable technique for severe arthritis. Many designs are available with different type of prosthesis it is important to study the outcome of prosthetic replacement. Different types of scoring system are used to assess the functional outcome. Of this the most important is the knee society scoring system. In 1989, the Knee Society published its revised knee rating system

Objectives of the Study: 1, To study the Functional Outcome of Advanced Osteoarthritis Knee Treated with Total Knee Arthroplasty.2, To compare the knee society knee score preoperatively and postoperatively

Methodology

Study Design: Prospective study

Study Setting: Department of Orthopedics, Government Medical College Thrissur.

Inclusion Criteria: 1, Patient with advanced arthritis knee as per radiological grading 2, Consenting patients 3, Age: Adult patients > 18 years4, Sex: Both male and female5, Physical fitness for surgery

Exclusion Criteria: 1, Patients managed conservatively for other medical reasons 2, Any comordity that prevents patient from early mobilisation 3, Pre-operative fractures 4, Post-operative infection

Sample Size: All patients attending orthopedics department of MCH Thrissur fulfilling inclusion criteria during the study period

Procedure: Key features of the proposed surgical technique includes General Anesthesia/Spinal Anesthesia, supine with knee in 90 degree flexion, Tourniquet control, midline skin incision, medial parapatellar approach, distal femoral cut at a valgus angle (usually 5 to 7 degrees), rotational alignment, Cut the tibia perpendicular to its mechanical axis with 0 to 5 degrees of posterior slope, GAP TECHNIQUE by spacer blocks, Femoral Sizer, Anterior, Posterior and Chamfer Resection, Tibial Stem Preparation, bone grafting of defects, Trial Reduction component placement, Extensor Mechanism Repair, wound closure. The patient was assessed 6 weeks post operatively for any signs of post operative infection. Once post operative infection was ruled out clinically the patient was assessed clinically and functionally using the Knee Society Score at an interval of 3 months and 6 months. Other complications were also looked for and treated appropriately.

Discussion: Elderly patients who were having difficulty in mobilizing because of degenerative arthritis found good relief after Total Knee Arthroplasty. All the parameters measured and results obtained were comparable with literature and the results were showing a excellent outcome

Conclusion: All the patients were treated with posterior cruciate substituting type of total knee arthroplasty. At 6 months follow up knee clinical score improved from an average of 27 to 87.90 showing an excellent outcome and knee functional score improved from an average of 40 to 81.05 showing an excellent outcome and patients were able to have pain free mobile joint.

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Corresponding Author

Dr Balagopalan K

Additional Professor In Orthopaedics, Govt Medical College, Thiruvananthapuram, India