Effectiveness of condylar constrained knee prosthesis for destructive hemophilic arthritis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

BIAN Yanyan , ZHAI Jiliang , PENG Huiming ,  WENG Xisheng , LIN Jin , JIN Jin , QIAN Wenwei , ZHAO Lijuan

Department of Orthopedics, Chinese Academy of Medical Sciences, Peking Union Medical College, Peking Union Medical College Hospital, Beijing, 100730, P.R.China;

Corresponding author：

WENG Xisheng, Email: xshweng@medmail.com.cn

Keywords：

Hemophilia; condylar constrained knee prosthesis; total knee arthroplasty

DOI：

10.7507/1002-1892.201609108

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the clinical outcomes of total knee arthroplasty (TKA) by using the condylar constrained knee prosthesis in the treatment of destructive hemophilic arthritis. Methods Between September 2007 and July 2015, 8 cases (8 knees) of destructive hemophilic arthritis accepted TKA by using condylar constrained knee prosthesis. All patients were male, aged 22 to 56 years, with an average age of 35 years. The disease course of hemophilia A was 3-30 years (mean, 17.3 years). Preoperative range of motion (ROM) was (68.1±32.6)°; the flexion deformity was (14.38±16.13)°. Six patients had valgus of 7-35° (mean, 17.3°), of whom, one had fixed dislocation of patella; and one had varus of 15°. Hospital for Special Surgery (HSS) knee score was 52.5±12.9. Pre-operative X-ray film examination demonstrated narrowing of the knee gap and cystic degeneration of articular cartilage and subchondral bone. Results All patients achieved primary wound healing, and were followed up 1-9 years (mean, 5 years). Tense blister with common peroneal nerve damage and extension penetrating into distal tibial cortex occurred in 1 case respectively, which were cured corresponding treatment. At last follow-up, the knee ROM and the flexion deformity were significantly improved to (98.1±8.9)° and (0.63±1.77)° (t=–2.527,P=0.036;t=2.396,P=0.047). At 2 weeks after operation and last follow-up, the HSS scores were significantly increased to 77.3±11.0 and 85.0±9.0 (P<0.05). X-ray film showed that lower extremity alignment returned to normal in patients with varus and valgus. Conclusion Good curative effect can be get by using condylar constrained knee prosthesis in TKA for the treatment of destructive hemophilic arthritis.

Citation： BIAN Yanyan, ZHAI Jiliang, PENG Huiming, WENG Xisheng, LIN Jin, JIN Jin, QIAN Wenwei, ZHAO Lijuan. Effectiveness of condylar constrained knee prosthesis for destructive hemophilic arthritis. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(3): 266-270. doi: 10.7507/1002-1892.201609108 Copy

1.	Öztürk, A, Akalin Y, Çevik N,et al. Posterior cruciate-substituting total knee replacement recovers the flexion arc faster in the early postoperative period in knees with high varus deformity: a prospective randomized study. Arch Orthop Trauma Surg, 2016, 136(7): 999-1006.
2.	Oliviu RC, Zazgyva A, Septimiu S, et al. Mid-term results of total knee replacement with single-radius versus multi-radius posterior-stabilized implants. Acta Orthop Traumatol Turc, 2016, 50(2): 125-131.
3.	Clatworthy M. Total Knee Replacement Plus Nonsurgical Treatment Was Better Than Nonsurgical Treatment Alone for Knee Osteoarthritis. J Bone Joint Surg (Am), 2016, 98(10): 873.
4.	Liao CY, Chan HT, Chao E, et al. Comparison of total hip and knee joint replacement in patients with rheumatoid arthritis and osteoarthritis: a nationwide, population-based study. Singapore Med J, 2015, 56(1): 58-64.
5.	Luque R, Rizo B, Urda A, et al. Primary modular total knee replacement in severe and unstable osteoarthritis. Predictive factors for failure. Int Orthop, 2015, 39(11): 2125-2133.
6.	Touzopoulos P, Drosos GI, Ververidis A, et al. Constrained Implants in Total Knee Replacement. Surg Technol Int, 2015, 26: 307-316.
7.	Frikha F, Marzouk S, Kaddour N, et al. Destructive arthritis in Behcet’s disease: a report of eight cases and literature review. Int J Rheum Dis, 2009, 12(3): 250-255.
8.	张卓, 关振鹏, 孙铁铮, 等. 血友病患者全膝置换围手术期的凝血因子替代治疗. 中国组织工程研究与临床康复, 2011, 15(22): 4023-4027.
9.	何超, 刘茂林, 张华文. 血友病性骨关节病影像学表现 (附 20 例分析). 实用放射学杂志, 2009. 25(9): 1294-1296.
10.	徐瑞燚, 赵永强, 康增寿, 等.³²磷胶体滑膜切除术治疗慢性血友病滑膜炎. 血栓与止血学, 2003, 9(2): 56-57, 60.
11.	李培勇, 陈刚, 张立颖, 等. 血友病关节炎的¹⁸⁸Re-硫化铼放射性滑膜切除研究. 中华血液学杂志, 2002, 23(3): 151-152.
12.	Zhang WQ, Han SQ, Yuan Z, et al. Effects of intraarticular (32)P colloid in the treatment of hemophilic synovitis of the knee: A short term clinical study. Indian J Orthop, 2016, 50(1): 55-58.
13.	Gilbert MS, Radomisli TE. Therapeutic options in the management of hemophilic synovitis. Clin Orthop Relat Res, 1997, (343): 88-92.
14.	Rodriguez-Merchan EC, Gomez-Cardero P. Arthroscopic knee debridement can delay total knee replacement in painful moderate haemophilic arthropathy of the knee in adult patients. Blood Coagul Fibrinolysis, 2016, 27(6): 645-647.
15.	Rodríguez-Merchán EC, Magallón M, Galindo E, et al. Hamstring release for fixed knee flexion contracture in hemophilia. Clin Orthop Relat Res, 1997, (343): 63-67.
16.	Wallny T, Eickhoff HH, Raderschadt G, et al. Hamstring release and posterior capsulotomy for fixed knee flexion contracture in haemophiliacs. Haemophilia, 1999, 5 Suppl 1: 25-27.
17.	Kiely PD, McMahon C, Smith OP, et al. The treatment of flexion contracture of the knee using the Ilizarov technique in a child with haemophilia B. Haemophilia, 2003, 9(3): 336-339.
18.	李其一, 翁习生, 秦泗河, 等. 改良 Illzarov 技术矫治血友病儿童双膝关节重度屈曲畸形. 中国骨与关节外科, 2011, 4(5): 422-425.
19.	冯宾, 翁习生, 林进, 等. 全膝关节置换术治疗甲型血友病性膝关节病变的疗效分析. 中华骨科杂志, 2010, 30(4): 363-368.
20.	童培建, 李陶冶, 俞楠泽, 等. 全膝关节置换术治疗甲型血友病性膝关节炎的短期疗效分析. 中华外科杂志, 2010, 48(10): 796-797.
21.	闫伟强, 贺西京, 张敏, 等. 全膝关节置换术治疗重型血友病性膝关节炎的临床研究. 中国骨与关节损伤杂志, 2013, 28(2): 153-154.
22.	高增鑫, 邱贵兴, 翁习生, 等. 关节成形术治疗血友病性关节病. 中华外科杂志, 2008, 46(11): 809-812.
23.	刘珂, 郑稼, 金毅, 等. 髁限制性膝关节假体在膝关节翻修中的临床应用研究. 中国实用医刊, 2013, 40(11): 27-29.
24.	彭慧明, 翁习生, 林进, 等. 初次全膝关节置换术后腓总神经麻痹的原因及处理. 中国骨与关节外科, 2010, 3(3): 198-203.
25.	冯宾, 翁习生, 林进, 等. 血友病性骨关节病变的外科治疗策略. 中华骨科杂志, 2016, 36(7): 413-421.

1. Öztürk, A, Akalin Y, Çevik N,et al. Posterior cruciate-substituting total knee replacement recovers the flexion arc faster in the early postoperative period in knees with high varus deformity: a prospective randomized study. Arch Orthop Trauma Surg, 2016, 136(7): 999-1006.
2. Oliviu RC, Zazgyva A, Septimiu S, et al. Mid-term results of total knee replacement with single-radius versus multi-radius posterior-stabilized implants. Acta Orthop Traumatol Turc, 2016, 50(2): 125-131.
3. Clatworthy M. Total Knee Replacement Plus Nonsurgical Treatment Was Better Than Nonsurgical Treatment Alone for Knee Osteoarthritis. J Bone Joint Surg (Am), 2016, 98(10): 873.
4. Liao CY, Chan HT, Chao E, et al. Comparison of total hip and knee joint replacement in patients with rheumatoid arthritis and osteoarthritis: a nationwide, population-based study. Singapore Med J, 2015, 56(1): 58-64.
5. Luque R, Rizo B, Urda A, et al. Primary modular total knee replacement in severe and unstable osteoarthritis. Predictive factors for failure. Int Orthop, 2015, 39(11): 2125-2133.
6. Touzopoulos P, Drosos GI, Ververidis A, et al. Constrained Implants in Total Knee Replacement. Surg Technol Int, 2015, 26: 307-316.
7. Frikha F, Marzouk S, Kaddour N, et al. Destructive arthritis in Behcet’s disease: a report of eight cases and literature review. Int J Rheum Dis, 2009, 12(3): 250-255.
8. 张卓, 关振鹏, 孙铁铮, 等. 血友病患者全膝置换围手术期的凝血因子替代治疗. 中国组织工程研究与临床康复, 2011, 15(22): 4023-4027.
9. 何超, 刘茂林, 张华文. 血友病性骨关节病影像学表现 (附 20 例分析). 实用放射学杂志, 2009. 25(9): 1294-1296.
10. 徐瑞燚, 赵永强, 康增寿, 等.³²磷胶体滑膜切除术治疗慢性血友病滑膜炎. 血栓与止血学, 2003, 9(2): 56-57, 60.
11. 李培勇, 陈刚, 张立颖, 等. 血友病关节炎的¹⁸⁸Re-硫化铼放射性滑膜切除研究. 中华血液学杂志, 2002, 23(3): 151-152.
12. Zhang WQ, Han SQ, Yuan Z, et al. Effects of intraarticular (32)P colloid in the treatment of hemophilic synovitis of the knee: A short term clinical study. Indian J Orthop, 2016, 50(1): 55-58.
13. Gilbert MS, Radomisli TE. Therapeutic options in the management of hemophilic synovitis. Clin Orthop Relat Res, 1997, (343): 88-92.
14. Rodriguez-Merchan EC, Gomez-Cardero P. Arthroscopic knee debridement can delay total knee replacement in painful moderate haemophilic arthropathy of the knee in adult patients. Blood Coagul Fibrinolysis, 2016, 27(6): 645-647.
15. Rodríguez-Merchán EC, Magallón M, Galindo E, et al. Hamstring release for fixed knee flexion contracture in hemophilia. Clin Orthop Relat Res, 1997, (343): 63-67.
16. Wallny T, Eickhoff HH, Raderschadt G, et al. Hamstring release and posterior capsulotomy for fixed knee flexion contracture in haemophiliacs. Haemophilia, 1999, 5 Suppl 1: 25-27.
17. Kiely PD, McMahon C, Smith OP, et al. The treatment of flexion contracture of the knee using the Ilizarov technique in a child with haemophilia B. Haemophilia, 2003, 9(3): 336-339.
18. 李其一, 翁习生, 秦泗河, 等. 改良 Illzarov 技术矫治血友病儿童双膝关节重度屈曲畸形. 中国骨与关节外科, 2011, 4(5): 422-425.
19. 冯宾, 翁习生, 林进, 等. 全膝关节置换术治疗甲型血友病性膝关节病变的疗效分析. 中华骨科杂志, 2010, 30(4): 363-368.
20. 童培建, 李陶冶, 俞楠泽, 等. 全膝关节置换术治疗甲型血友病性膝关节炎的短期疗效分析. 中华外科杂志, 2010, 48(10): 796-797.
21. 闫伟强, 贺西京, 张敏, 等. 全膝关节置换术治疗重型血友病性膝关节炎的临床研究. 中国骨与关节损伤杂志, 2013, 28(2): 153-154.
22. 高增鑫, 邱贵兴, 翁习生, 等. 关节成形术治疗血友病性关节病. 中华外科杂志, 2008, 46(11): 809-812.
23. 刘珂, 郑稼, 金毅, 等. 髁限制性膝关节假体在膝关节翻修中的临床应用研究. 中国实用医刊, 2013, 40(11): 27-29.
24. 彭慧明, 翁习生, 林进, 等. 初次全膝关节置换术后腓总神经麻痹的原因及处理. 中国骨与关节外科, 2010, 3(3): 198-203.
25. 冯宾, 翁习生, 林进, 等. 血友病性骨关节病变的外科治疗策略. 中华骨科杂志, 2016, 36(7): 413-421.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of condylar constrained knee prosthesis for destructive hemophilic arthritis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content