Features and Results of Knee Arthroplasty after Knee Fractures Fixation

Abstract

Abstract
 The purpose of the study - to find out surgical intervention features, the function restoration dynamics and clinical results after primary total knee replacement (TKA) in patients with a history of osteosynthesis of intra-articular fractures, to assess the risk of complications and to suggest measures for their prevention. Material and methods. The study includes a retrospective (100 observations) and prospective (40 observations) comparative analysis of the results of primary TKA in patients with a history of osteosynthesis of intra-articular fractures (MOS) of the bones forming the knee joint (main group) and without them (comparison group). Adapted Russian-language versions of the KSS, WOMAC and FJS-12 score scales were used to study the clinical and functional results of the TKA, the incidence of any complications after arthroplasty and the X-ray position of the endoprosthesis components on the KRESS scale were evaluated. Statistical analysis of the data obtained was carried out in accordance with generally accepted methods. Results. Statistically significant differences were revealed between the patients of the main and the comparison groups according to the following indicators: the patients of the main group were 8 years younger, the duration of the operation time, the volume of intraoperative blood loss, the need for implantation of structures with an increased degree of mechanical coupling between the components of the endoprosthesis, the number of postoperative complications were greater in the patients of the main group. Functional results on the KSS and WOMAC scales did not have statistically significant and clinically differences, when assessing the satisfaction of TKA on the FJS-12 scale, statistically significantly worse results were obtained in the main group. TKA in patients with a history of MOS for intraarticular fractures of the knee joint area statistically and clinically significantly increased the amplitude of movements in the knee joint - from 89 to 108 , that is, by 19 , the function recovery dynamics according to the KSS, WOMAC and FJS-12 scales was slowed down at 3 and 6 months, and according to the WOMAC and FJS-12 scales and by 12 months after surgery. Conclusion. The trauma and subsequent surgical treatment of intra-articular fractures of the knee joint leads to an earlier development of posttraumatic arthritis of the 3rd degree, functional results have no statistically significant differences, satisfaction with the results of TKA in this category of patients is less, and the number of postoperative complications, are greater. A history of MOS significantly slows down the dynamics and degree of recovery of function in the early postoperative period.