Abstract：Objective To compare the clinical effect of the different osteotomy order in Total knee arthroplaty (TKA).Methods The clinical data of 80 cases in the Provincial Hospital Affiliated to Anhui Medical university from november 2010 to september 2013 were retrospectively analyzed. Eighty cases of TKA were divided into two group: oberservation group (distal femur osteotomy first) and control group (tibial osteotomy first). The operative time, anteroposterior diameter of lateral and medial tibial plateau exposed in the operation, postoperative drainage, range of motion(ROM) of knee and HSS score of all cases were evaluated and statistically analyzed.Results The follow-up time of 80 cases was 6 to 14 months. The operative time and postoperative drainage of oberservation group were (53.4±13.8)min and(310±46)ml. The operative time and postoperative drainage of control group were (72.5±14.7)min and(425±40)ml. The differences were statistically significant (t=5.99, t=11.93, all P values<0.01). The anteroposterior diameters of lateral tibial plateau exposed in the operation of oberservation group and control group were (44.1±3.7)mm and(21.8±3.3)mm. The difference of two groups was statistically significant (t=28.45, P<0.01). The anteroposterior diameters of medial tibial plateau exposed in the operation of oberservation group and control group were (45.6±3.5)mm and (43.5±4.2)mm. The difference of two groups was not statistically significant (t=2.43, P＞0.05). The ROMs of knee after 6 weeks and 12 weeks of operation of oberservation group were 87.6°±14.2° and 103.6°±7.4°. The ROMs of knee after 6 weeks and 12 weeks of operation of control group were 88.6°±13.6° and 102.3°±6.8°. The differences of two groups were not statistically significant (t=0.32, t=0.82, all P values＞0.05). The HSS scores after 6 weeks and 12 weeks of operation of oberservation group were (90.12±8.6) and (91.66±6.6). The HSS scores after 6 weeks and 12 weeks of operation of control group were (89.45±9.9) and (91.87±7.5). The differences of two groups were not statistically significant (t=0.32, t=0.13, all P values＞0.05 ).Conclusions Distal femur osteotomy first in TKA can fully expose tibial plateau, simplify surgical procedure and reduce surgical trauma.
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i Shoumin, Kong Rong, Xu Wei, Shang Xifu, Xia Rui. Comparison of two kinds of osteotomy order in total knee arthroplasty. Chinese Journal of Anatomy and Clinics, 2014, 19(5): 411-414.
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