残留内翻对弓形股骨患者全膝关节置换术后功能恢复的影响

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Abstract Objective To explore the effect of remaining mild varus on postoperative functional recovery after total knee arthroplasty (TKA) in patients with femoral bowing. Methods A retrospective review of aprospectively maintained data base were performed.We retrospectively analyzed 59 patients (71 knees) of undergoing TKA by the same surgeon，including 6 cases (8 knees) of males and 53 cases(63 knees) of females，from January of 2015 to December of 2015.Mean age of patients was (67.7±5.7)(range 58~82).Femoral bowing Angle and hip-knee-ankle Anglewere measured.FBA<177° was defined as the femoral bowing.Patients were divided into two groups according to the postoperative HKA angle from weight-bearing full-leg radiographs：varus malalignment group with 32 patients (37 knees)，HKA<177°；neutral alignment groupwith 27 patients (34 knees)，HKA was (180±3)°.The Knee Society Score (KSS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were compared between preoperative and postoperative.Results Mean of follow-up was (49.30±4.11)months (range，43~55 months).No revisions occurred in any of the groups at midtermfollow-up.There were no statistical difference in preoperative KSS and WOMAC scores.All patients improved between preoperative and post-operative timepoints(P＜0.05).The WOMAC total score of varus malalignment group(5.57±6.23) were significantly lower than that in the neutral alignment group (9.27±8.86)；the WOMACpart C score of varus malalignment group(4.95±5.87)were significantly lower than that in the neutral alignment group(8.24±7.68).There was no significant difference in the remaining scores (P＜0.05).Conclusion For patients with lateral femoral bowing，residual varus alignment leads to better clinical outcomes after TKA than neutral alignment at a mean follow-up of 49.3 months.However，The effect of residual varus alignment on the survivalship of the prosthesis and the long-term outcome needs to be further evaluated.

Key words： femoral bowing alignment of lower limb total knee arthroplasty

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[1]	. [J]. sygkzz, 2021, 27(3): 272-276.