Application of the angle measurement pad of flexion gap in the treatment of total knee arthroplasty
Fan Zongqing1, Fu Donglin1, Pan Tan1, Liu Kun1, Yu Changxiu2, Nie Yu1
1Department of Orthopaedics, Fuyang People's Hospital (Fuyang People's Hospital Affiliated to Anhui Medical University), Fuyang 236000, China; 2Major in Anesthesia, Grade 2021, the First Clinical College of Anhui Medical University, Hefei 230022, China
Abstract：Objective This study aimed to explore the application value of the angle measurement pad of flexion gap in total knee arthroplasty (TKA). Methods A prospective randomized controlled study was conducted. Fifty-six patients with knee osteoarthritis who were admitted in Fuyang People's Hospital from February 2019 to December 2021 were selected in this study, including 17 males and 39 females, aged 59-78 (68.5±4.5) years. Fifty-six patients were divided into observation group and control group by simple random sampling. Twenty-six patients in the observation group were treated with the angle measurement pad of flexion gap to complete TKA. Thirty patients in the control group, the conventional measured resection technique with 3° external rotation of distal femur was used to complete TKA. Outcome measurements: (1) The clinical baseline data such as sex, age, and side were compared between the two groups. (2) The operation time, perioperative blood loss, and the number of initial flexion asymmetry (IFA) cases were compared between the two groups, the position of postoperative prosthesis and wound healing after operation were observed. (3) Regular follow-up was performed to observe the occurrence of operative complications such as limited flexion function and abnormal sound of knee joint during the follow-up period, and the knee varus angle and rotation error of femoral prosthesis were observed 3 months after operation. One year after operation, pain was evaluated by using the visual analogue scale (VAS); clinical and functional scores of the knee joint were evaluated by using the knee society score (KSS), and the range of motion (ROM) of the knee was measured to evaluate the improvement of knee joint activity. The above mentioned indexes were compared between the two groups. Results (1) No significant difference in baseline data was observed between the two groups (all P values >0.05). (2) In addition, no significant difference in operation time and blood loss was found between the two groups (all P values >0.05). Intraoperative IFA was observed in two cases in the observation group and 16 cases in the control group, and the incidence of IFA in the observation group (7.7%,2/26) was lower than that in the control group (53.3%,16/30), with statistical significance (χ2=13.30, P<0.001). The X-ray films of the anterior and lateral positions of the knee joint were reexamined after operation, and the position of the prosthesis was good. The incisions of the patients healed in one stage after operation. (3) All the 56 patients were followed up for 14-25 (21.0±3.2) months. During the follow-up period, one case of knee stiffness was identified in the observation group, and two cases of knee stiffness and one case of abnormal sound were identified in the control group. No significant difference in the incidence of postoperative complications was observed between the two groups (χ2=0.14, P=0.710). Three months after operation, the rotation error of femoral prosthesis in the observation group (0.4°±1.7°) was significantly lower than that in the control group (1.4°±1.0°). The difference was statistically significant (t=2.66, P=0.008), but no significant difference in knee varus angle was found between the two groups (t=0.73, P=0.468). One year after surgery, the VAS score of the observation group was 1.3±0.6, which was lower than that of the control group (2.2±1.1). The KSS clinical efficacy score (91.2±2.9), knee joint function score (91.1±4.3), and knee joint ROM (106.9°±10.6°) were higher than those of the control group (88.0±6.2, 86.8±4.6, and 90.9°±18.2°, respectively). The differences were statistically significant (t=3.65, 2.45, 3.61, 3.96, all P values <0.05). Conclusion The angle measurement pad of flexion gap can be used to adjust the angle of external rotation osteotomy of the distal femur in TKA, which promotes flexion balance, reduces trauma, and improves the short-term clinical effect.
樊宗庆, 符东林, 潘檀, 刘坤, 郁长修, 聂宇. 屈曲间隙角度测量垫块在全膝关节置换术中的应用[J]. 中华解剖与临床杂志, 2023, 28(8): 540-552.
Fan Zongqing, Fu Donglin, Pan Tan, Liu Kun, Yu Changxiu, Nie Yu. Application of the angle measurement pad of flexion gap in the treatment of total knee arthroplasty. Chinese Journal of Anatomy and Clinics, 2023, 28(8): 540-552.
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2023, Vol. 28 
