THE ADVANTAGES OF MINIMAL BONE CUTS RESECTION IN TOTAL KNEE REPLACEMENT

Abstract

. Introduction. Total knee arthroplasty (TKA) is one of the most successful and effective surgical options for reducing pain and restoring function in patients with severe osteoarthritis. Patient satisfaction is one of many outcome measures reported by patients. Purpose of the study. To clinically investigate the effectiveness of total knee arthroplasty (TKA) in the treatment of deforming diseases of the knee joint (KJ), as well as to demonstrate a high level of effectiveness of minimal bone cuts in TKA. Patient satisfaction can be assessed in two categories: satisfaction determinants and satisfaction components. The former have been described as all patient-related factors, including age, gender, personality traits, patient expectations, medical and psychiatric comorbidities, patient diagnosis leading to TKA, and severity of arthropathy. The latter include all processes and technical aspects of performing TKA, ranging from anesthetic and surgical factors, type of implants and postoperative rehabilitation. Materials and Methods. For the period from 2015-2018, on the basis of the orthopedic department of KCH No. 7 and LEH of the city of Lviv, 1250 patients were operated on for arthrosis of the knee joint. Total cement arthroplasty was performed by the authors of the article using NexGen (Zimmer, USA) and Sigma (DePuy, Johnson&Johnson, USA) endoprostheses. Both models with preservation of the posterior cruciate ligament (75%) and without preservation of the posterior cruciate ligament (25%) were used. In both cases, only a fixed platform was used. Results and its discussion. Based on the experience of more than 1250 knee replacements from 2015-2018 wasestablished than minimal bone cuts in knee replacements give more superior resultsand survival probability.We strongly believe that should be a reasonable balance when do you perform«traditional» knee replacement between bone cuts and soft tissue. Arthrosis with varus deformity of the knee joint was observed in 82% of cases, valgus deformity of the knee, respectively, was in 18% of patients. Among the patients, women predominated (72%), the age of the patients ranged from 42 to 86 years, with an average of 69 years. Conclusions. Thus, although total knee arthroplasty is an effective treatment for late stages of knee arthrosis, the percentage of dissatisfied patients reaches up to 30% (3,4,5). Based on our research, the number of patients “satisfied” with the results of the operation was mainly observed in the group where minimal bone cuts and “smart” soft tissue balance were performed. This approach seems especially appropriate in the light of future revision prosthetics.

Keywords

• knee joint,total arthroplasty,rehabilitation,prosthesis,deformity,arthrosis.