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Phenotype‑considered kinematically aligned total knee arthroplasty for windswept‑deformity‑associated osteoarthritis: surgical strategy and clinical outcomes

Cheng‑En Hsu|Meng‑Hsueh Tsai|Hsin‑Ting Wu|Jen‑Ting Huang|Kui‑Chou Huang
대한슬관절학회 (Korean Knee Society)|2024.12|Knee Surgery and Related Research|제36권 |pp. 16-16|DOI 10.1186/s43019-024-00220-x

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키워드

ScoliosisLeg length discrepancyKnee arthroplastyWindswept deformitiesKinematically aligned total knee arthroplasty

초록

Background Windswept deformity (WSD) in relation to advanced osteoarthritis (OA) presents a significant surgical challenge in total knee arthroplasty (TKA). The primary goal of this study is to investigate the Prevalance of WSD associated osteoarthritis who have undergone total knee arthroplasty. The secondary goal is to explore the causes of WSD and its association with spinal deformity or leg length discrepancy in these patients. Finally, we evaluate the surgical outcomes of phenotype-considered kinematically aligned TKA (KA-TKA) in treating patients with WSD. Methods A review was conducted on data from 40 knees of 33 WSD patients who underwent phenotype-considered KA-TKA from August 2016 to December 2020. Patient demographics, associated diseases, preoperative and postoperative knee alignment angles, range of motion (ROM), Oxford Knee Score (OKS), and Knee Society Score (KSS) were collected and analyzed. Subgroup analysis for comparing the results between valgus and varus knees were also performed. Results Within the studied cohort of WSD patients, a substantial 64% displayed concomitant coronal spinal imbalance and 21% evidenced leg length discrepancy. Postoperative improvements were notable in knee alignments, ROM, OKS, and KSS following the application of the phenotype-considered KA-TKA approach. There were significant differences in the knee alignment angles, including mHKA, LDFA, and MPTA, between the valgus and varus side of knees (P = 0.018). However, no statistically significant difference were observed in the functional scores, comprising ROM, OKS, and KSS, between valgus and varus knees. Conclusions A high percentage of patients with WSD exhibited coronal spinal imbalance and leg length discrepancy. Phenotype-considered KA-TKA effectively provided alignment targets for the treatment of both varus and valgus knees in patients with WSD, achieving excellent short-term outcomes and acceptable knee alignment.

Abstract

Background Windswept deformity (WSD) in relation to advanced osteoarthritis (OA) presents a significant surgical challenge in total knee arthroplasty (TKA). The primary goal of this study is to investigate the Prevalance of WSD associated osteoarthritis who have undergone total knee arthroplasty. The secondary goal is to explore the causes of WSD and its association with spinal deformity or leg length discrepancy in these patients. Finally, we evaluate the surgical outcomes of phenotype-considered kinematically aligned TKA (KA-TKA) in treating patients with WSD. Methods A review was conducted on data from 40 knees of 33 WSD patients who underwent phenotype-considered KA-TKA from August 2016 to December 2020. Patient demographics, associated diseases, preoperative and postoperative knee alignment angles, range of motion (ROM), Oxford Knee Score (OKS), and Knee Society Score (KSS) were collected and analyzed. Subgroup analysis for comparing the results between valgus and varus knees were also performed. Results Within the studied cohort of WSD patients, a substantial 64% displayed concomitant coronal spinal imbalance and 21% evidenced leg length discrepancy. Postoperative improvements were notable in knee alignments, ROM, OKS, and KSS following the application of the phenotype-considered KA-TKA approach. There were significant differences in the knee alignment angles, including mHKA, LDFA, and MPTA, between the valgus and varus side of knees (P = 0.018). However, no statistically significant difference were observed in the functional scores, comprising ROM, OKS, and KSS, between valgus and varus knees. Conclusions A high percentage of patients with WSD exhibited coronal spinal imbalance and leg length discrepancy. Phenotype-considered KA-TKA effectively provided alignment targets for the treatment of both varus and valgus knees in patients with WSD, achieving excellent short-term outcomes and acceptable knee alignment.

참고문헌 (40)

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관련 논문AI추천

Windswept deformities of the knee are challenging to manageBabu Suresh, Vaish Abhishek, Vaishya Raju대한슬관절학회 · Knee Surgery and Related Research2020 · 제32권 Relationship between Lateral Femoral Bowing and Varus Knee Deformity Based on Two­-Dimensional Assessment of Side-to­-Side Differences조명래, 최원기, Young Sik Lee대한슬관절학회 · Knee Surgery and Related Research2018 · 제30권 제1호Navigation-Assisted Total Knee Arthroplasty for Patients with Extra-Articular Deformity서정탁, 서창효, 이승준대한슬관절학회 · Knee Surgery and Related Research2013 · 제25권 제4호Short knee radiographs can be inadequate for estimating TKA alignment in knees with bowingBum-Sik Lee, Jae-Young Kim, Jong-Min Kim, Seong-Il Bin, Sung-Mok Oh대한슬관절학회 · Knee Surgery and Related Research2020 · 제32권 Effects of Femoral Lateral Bowing on Coronal Alignment and Component Position after Total Knee Arthroplasty: A Comparison of Conventional and Navigation­-Assisted Surgery이창락, Chang-Wan Kim대한슬관절학회 · Knee Surgery and Related Research2018 · 제30권 제1호Preserving coronal knee alignment of the knee (CPAK) in unicompartmental knee arthroplasty correlates with superior patient-reported outcomes윤국로, 이명철, 이재민, Hyuk‑Soo Han, Sung Eun Kim대한슬관절학회 · Knee Surgery and Related Research2024 · 제36권

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