Objective To summarize and analyze the operation-correlated compl ications of total knee arthroplasty (TKA)with posterior stabil ized prosthesis (PS). Methods From October 2000 to October 2007, 707 cases (816 knees) underwent TKA. All the TKA knees were divided equally into former and latter groups according to the operation time (408 knees for each group). In the former group (October 2000 to January 2005, n=350), there were 63 males (84 knees) and 287 females (324 knees), aging (63.5 ± 7.8) years. A total of 198 left knees affected and 210 right knees affected; 292 single kneesaffected and 58 both knees affected. There were 304 knees of osteoarthritis, 84 knees of rheumatoid arthritis and 20 knees of other disease. The disease course was (9.3 ± 5.6) years. The knee range of motion (ROM) was (97.2 ± 8.7)°, the HSS score was 47.4 ± 12.2. In the latter group (January 2005 to October 2007, n=357), there were 77 males (92 knees) and 280 females (316 knees), aging (62.7 ± 6.3) years. A total of 221 left knees affected and 187 right knees affected; 306 single knees affected and 51 both knees affected. There were 278 knees of osteoarthritis, 109 knees of rheumatoid arthritis and 21 knees of other disease. The disease course was (8.6 ± 5.1) years. The knee ROM was (101.1 ± 10.3)°, the HSS score was 49.3 ± 11.2. We modified the method of lateral patellar retinaculum release and used a new femoral rotational al ignment technique in the latter group. The intraoperative and postoperative compl ications were divided into mild, moderate and severe. The HSS score, ROM and compl ications of the knee were compared and analyzed statistically during the follow-up. Results The former group was followed up 5.3 years (1 to7 years), compl ications occurred in 278 knees (68.1%), including mild in 136 knees (33.3%), moderate in 135 knees (33.1%) and severe in 7 knees (1.7%). The latter group was followed up 2.1 years (0.5 to 3.5 years), compl ications occurred in 159 knees (39.0%), including mild in 111 knees (27.2%), moderate in 47 knees (11.5%) and severe in 1 knee (0.2%), and there was significant difference between them (P lt; 0.001). There was significant difference in increased ROM between the former group (6.0 ± 3.7)° and the latter group (14.4 ± 4.2)° after operation (P lt; 0.05). There was significant difference in increased HSS score between the former group (36.9 ± 3.7)and the latter group (44.0 ± 4.2) after operation (P lt; 0.05). Conclusion The TKA is a complex operation with innumerable potential compl ications. To accumulate operative experience and improve surgical skills are the key points to reduce the operation-correlated compl ications.
Objective To evaluate the efficacy of modified Ranawat soft tissue balance technique on total knee arthroplasty (TKA). Methods From January 2004 to June 2008, 34 cases (44 knees) of valgus deformity were treated with TKA. There were 5 males (5 knees) and 29 females (39 knees), aged 55-79 years old (average 60.3 years old) and including 18 left knees and 26 right knees. The deformity was caused by osteoarthritis in 9 cases, by rheumatoid arthritis in 19 cases, and bytraumatic arthritis in 6 cases. According to Ranawat classification, there were 5 cases (5 knees) of type I and 29 cases (39 knees) of type II. All patients were performed modified Ranawat soft tissue balance technology. Results The operative time was (65 ± 7) minutes. Burst fracture of femoral condyle occurred and internal fixation was selected in 1 case of rheumatoid arthritis. Small incision necrosis occurred and healed after debridement in 1 case of rheumatoid arthritis. Incision healed by first intention in other cases. Adhesions occurred in 1 case (1 knee) and hydrarthrosis in 4 cases (4 knees), all cured after symptomatic treatment. All patients were followed up 6 months to 5 years with an average of 2.6 years. All patients had no compl ications of deep vein thrombosis, dislocation, vascular injury and nerve injury. X-ray films showed no signs of prosthesis loosening and infection at 1 year after operation. The X-ray films showed statistically significant differences (P lt; 0.05) in anatomic valgus angulation between preoperation and 1 week after operation [(25.4 ± 3.1)° vs (3.8 ± 1.2)°]. There were statistically significant differences in modified KSS score between preoperation and 1, 2 years postoperatively (P lt; 0.05). Conclusion It is a simple and effective way to treat the valgus deformity with modified Ranawat soft tissue balance technique in TKA, which can achieve the satisfactory results in the knee stabil ity, the range of motion and the deformity correction