Objective To analyze the clinical efficacy of total knee arthroplasty (TKA) with posterior cruciate ligament retaining (CR) prosthesis and posterior-cruciate substituting (PS) prosthesis in the treatment of knee osteoarthritis complicated with knee valgus deformity.Methods From May 2019 to May 2021, 60 patients with knee osteoarthritis complicated with knee valgus deformity who were treated in the Affiliated Ganzhou Hospital of Nanchang University were retrospectively analyzed. They were all treated with primary unilateral TKA, 30 patients were treated with CR prosthesis (CR group) and 30 patients were treated with PS prosthesis (PS group). The operation time, intraoperative blood loss, postoperative drainage volume, the decrease of hemoglobin (Hb) on the 3rd day after operation and the occurrence of deep vein thrombosis were compared between CR and PS groups. The knee valgus angle before and after the operation was compared between the two groups; the visual analogue score (VAS) of pain, range of motion (ROM) of knee joint and hospital for special surgery knee score (HSS) were compared between the two groups at 1 week, 1 month, 3 months, 6 months and 1 year after TKA operation.Results All the 60 patients completed TKA successfully, and all patients were followed up for 13-28 months, with a mean time of (18.51±0.90) months. The intraoperative bleeding volume, postoperative drainage volume and the decrease of Hb on the 3rd day after operation in the CR group were lower than those in PS group (P<0.05). There was no significant difference in operation time and postoperative deep venous thrombosis between the CR and PS groups (P>0.05); there was no significant difference in the knee valgus angle between the CR and PS groups before and after operation (P>0.05). Compared with PS group, the VAS scores of CR group was lower at 1 week and 1 month after TKA operation (P<0.05), and there was no significant difference in VAS score at 3 months, 6 months and 1 year after operation between the CR and PS groups (P>0.05). The ROM and HSS scores of knee joint in CR group were better than those in PS group at 1 week, 1 month and 3 months after operation (P<0.05). There were no significant differences in the ROM of knee joint and the HSS scores of knee joint at 6 months and 1 year after operation between the CR and PS groups (P>0.05).Conclusion TKA with CR or PS prosthesis in the treatment of knee osteoarthritis combined with knee valgus deformity can effectively correct knee deformity, reduce knee pain, improve knee mobility and function, and achieve satisfactory clinical results. However, compared with PS prosthesis, CR prosthesis retains the posterior cruciate ligament, reduces the amount of osteotomy at the femoral condyle, thus reducing surgical bleeding, better alleviating early postoperative pain, and contributing to early functional recovery after TKA. |