何 勇(He Yong，Dept Orthop，Shanghai Guanghua Hosp，Shanghai 200052)…∥Chin J Orthop.－2010，30(12).－1175～1180

Primary total knee arthroplasty in treatment of stiff knee

何 勇(He Yong，Dept Orthop，Shanghai Guanghua Hosp，Shanghai 200052)…∥Chin J Orthop.－2010，30(12).－1175～1180

ObjectiveTo evaluate the outcome of primary total knee arthroplasty(TKA)in treatment of stiff knee，and discuss the key points of operative technique and rehabilitation.MethodsFrom February 2005 to April 2009，23 patients with 34 stiff knees were treated with primary TKA.The study included 3 males(4 knees)and 20 females(30 knees)，with the mean age of 56.9 years.Primary disease of the patients included rheumatoid arthritis(26 knees in 15 cases)and osteoarthritis(8 knees in 8 cases).Varus deformity was found in 10 knees(5°－ 15°)，and valgus was found in 5 knees(5°－10°).Evaluations included preoperative and postoperative range of motion(ROM)measurement，hospital for special surgery knee score(HSS)，blood loss，operative time and assessment of postoperative complications.Re-sults All patients were followed up.The mean followup time was 32.2(range，24 to 40)months.At the final follow-up visit，the HSS score increased from 42.9 ±5.2 preoperatively to 85.7 ± 4.3，the range of motion increased from 42.6°± 5.7°preoperatively to 89.2°±10.5°.Sixteen knees in 12 cases underwent manipulation at 3 to 8 weeks postoperatively for unsatisfied ROM，but ROM was still less than 90°in 8 knees at the last followup.The average blood loss were(632.4 ±180.2)mL in first 24 hours(450－850 mL)and the operative time were(98.1 ±18.6)min(80 －150 min).Deep venous thrombosis was found in 3 patients.All the symptoms relieved after anticoagulant therapy.Postoperative varus deformity was seen in one patient，but the function of knee was good.No revision was needed.ConclusionPrimary total knee arthroplasty is reliable method in treatment of stiff knees.Sufficient soft tissue release during the operation，postoperative muscle strength exercise and essential manipulation are key points for satisfactory outcomes.11 refs，2 figs，1 tab.

(Authors)