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07 August 2017 : Clinical Research  

Reduction Osteotomy versus Extensive Release on Clinical Outcome Measures in Simultaneous Bilateral Total Knee Arthroplasty

Pengfei Zan1ABCDEF, Lin Fan1BCDEF, Kaiyuan Liu1BCD, Yong Yang2BCF, Shuo Hu1ADEG*, Guodong Li1ADEG

DOI: 10.12659/MSM.905815

Med Sci Monit 2017; 23:3817-3823

Abstract

BACKGROUND: During total knee arthroplasty (TKA) in varus knee deformities, reduction osteotomy (RO) and medial soft tissue release are alternative techniques to aid in achieving deformity correction. In this study, we investigated the effect of RO compared to extensive medial soft tissue release (ER) on clinical outcome measures in simultaneous bilateral TKA.

MATERIAL AND METHODS: We prospectively enrolled 24 patients (48 knees) with bilateral varus knee deformity from July 2014 to December 20l5. For each patient, one knee was assigned to the RO group and the contralateral knee was assigned to ER group. One year postoperative, follow-up outcomes were collected and analyzed.

RESULTS: Time to 90° flexion of the knee was significantly different in the RO group (1.6±0.3 days) compared to the ER group (2.0±0.4 days) (p<0.001). Using a 10-item patient reported outcome questionnaire, total scores were significantly different between the RO group (86.3±3.2) and the ER group (82.4±2.7) (p<0.001). Analysis of variance showed a significant difference on the visual analogue scale (VAS) score (p<0.001) but no significant difference in the range of motion (ROM) of the knee (p>0.05) during the follow-up year.

CONCLUSIONS: Knees treated with RO were associated with greater improvements in pain and function than knees treated with conventional ER technique. Additionally, RO technique did not confer an increased risk for adverse clinical outcomes. RO may therefore by a safe method to decrease postoperative pain, achieve earlier functional recovery, and increase patients’ subjective satisfaction after TKA.

Keywords: Arthroplasty, Replacement, Knee, Osteotomy, Therapy, Soft Tissue, visual analog scale

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750