初次TKA治疗伴AORIⅡa型胫骨缺损的严重膝内翻骨关节炎

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Abstract Objective To explore the surgical technique and short-term effect of AORI Ⅱa type tibial defects of osteoarthritis with varus knee in primary total knee arthroplasty.Methods Eight patients (10 knees) suffered from severe genu varum and osteoarthritis and AORI Ⅱa type tibial defects.There were 3 knees of male patients and 7 knees of female patients.The average age was(68.8±6.7) years (from 61 to 79 years).Posterior CruciateStabilizing Total Knee Prostheses were used for all patients.Varus deformity were corrected by removal of the osteophytes，outward shift of osteotomy，selected soft tissue release.Met al block and stem extension were used for all patients，autologous bone graft for 2 knees.The range of motion and X-ray were observed regularly and the results were evaluated according to Lysholmscores.Results Intraoperative soft tissue balance was good，and restricted met al block was not used.The patients were followed up for 14~50 months (average 26 months) after operation.The Lysholm score was (25.16±5.04) before operation，(85.4±10.3) at last follow-up.The ROM was (61.37±10.24) ° before operation，(86.1±11.4)° at last follow-up.At the last follow-up，there was no complication of tibial plateau collapse and prosthesis loosening.ROM and Lysholm scores were significantly better than those before surgery(P＜0.05).Conclusion The short-term effectiveness of total knee arthroplasty using removal of the osteophytes，outward shift of osteotomy，selected soft tissue release，met al block augmentation and stem extension for AORI Ⅱa type tibial defects and varus knee deformity is satisfactory.Satisfactory alignment，stability of the tibia prosthesis and function of knee can be achieved.

Key words： knee arthroplasty varus knee deformity soft tissue release bone defect

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