| Objective To investigate the influence of preoperative knee varus and valgus deformity on the curative effect after total knee arthroplasty(TKA).Methods A retrospective analysis was performed on 174 patients(178 knees) who underwent primary total knee arthroplasty in Renmin Hospital of Wuhan University from March 2016 to June 2020. According to the preoperative hip-knee-ankle angle of the affected limb, the patients were divided into group A (knee varus≤10°), group B (10°<knee varus≤20°), group C (knee valgus≤10°), and group D(10°<knee valgus≤20°). There were 27 males and 147 females; the age ranged from 65 to 88 years, with an average of (72.8±6.2) years. The HKA angle on the operation side before operation and 1 week after operation were recorded, and ROM, HSS and AKS scales were used to evaluate the knee joint function before operation and at the last follow-up. VAS scale was used to evaluate the subjective feeling of the knee joint on the operation side, and the AOFAS scale was used to evaluate the ankle joint function of the operation side. Correlation analysis and inter-group comparison analysis were carried out on the above indicators.Results All 174 patients were followed up as planned. The follow-up time was 15 to 66 months, with an average of (42.0±16.0) months. At 1 week after TKA, the HKA angle in each group was significantly improved compared with that before operation (P<0.05). At the last follow-up, HSS, ROM, AKS, AOFAS were significantly improved compared with those before operation (P<0.05); VAS was significantly lower than that before operation (P<0.05). The preoperative indexes, postoperative HKA and excellent rate, and AOFAS scores of different degrees of varus/valgus were compared, the more severe varus/valgus was, the worse the results were (P<0.05). Postoperative HSS, ROM, AKS scores, and VAS scores were not significantly different (P>0.05). The preoperative HKA angle of patients with knee varus was correlated with preoperative HSS, ROM, AKS, VAS, AOFAS scores and postoperative AOFAS score (P<0.05), but was not correlated with postoperative HSS, ROM, AKS, VAS scores (P>0.05). The preoperative HKA angle of patients with knee valgus was negatively correlated with preoperative HSS, ROM, AKS, AOFAS scores and postoperative AOFAS score (P<0.05), but was not correlated with postoperative HSS, ROM, AKS, VAS scores and preoperative VAS score (P>0.05).Conclusion From the mid-term follow-up, the severity of varus and valgus deformities before operation had a significant impact on the excellent rate of postoperative HKA alignment, postoperative ankle joint function and preoperative knee joint function, but had no significant effect on postoperative knee joint function. |
