PURPOSE: The treatment of elderly KBD knee remains a significant clinical challenge, and clinical data are lacking. This study aimed to prospectively determine the functional outcomes of total knee arthroplasty (TKA) in adult patients with severe Kashin-Beck disease (KBD) of the knee. METHOD: Fifteen cases that included 18 occurrences of KBD of the knee were treated by primary knee arthroplasty and followed up for at least two years. Clinical assessments for each patient were performed at time zero (pre-operatively), one, three, six and 12 months and yearly thereafter. The efficacy measures included the visual analogue scale (VAS) pain score, Hospital for Special Surgery (HSS) score, and Functional Score for Adult Tibetans with Kashin-Beck Disease (FSAT-KBD) as well as radiographic findings. RESULTS: All patients were followed for a mean length of 32.47±10.05 months. All force lines in the lower limbs had been improved significantly. No radiographic evidence of loosening or changes in component positioning was observed at the last follow up. The VAS decreased significantly during the first six months after surgery and was maintained until the last follow up (p < 0.01). Similar trends were found in both HSS and FSAT-KBD, which increased significantly post-operatively (p < 0.01). CONCLUSION: Knee arthroplasty can reduce pain and improve function in patients with severe KBD of the knee. Additional studies will be necessary to confirm our findings.
PURPOSE: The treatment of elderly KBD knee remains a significant clinical challenge, and clinical data are lacking. This study aimed to prospectively determine the functional outcomes of total knee arthroplasty (TKA) in adult patients with severe Kashin-Beck disease (KBD) of the knee. METHOD: Fifteen cases that included 18 occurrences of KBD of the knee were treated by primary knee arthroplasty and followed up for at least two years. Clinical assessments for each patient were performed at time zero (pre-operatively), one, three, six and 12 months and yearly thereafter. The efficacy measures included the visual analogue scale (VAS) pain score, Hospital for Special Surgery (HSS) score, and Functional Score for Adult Tibetans with Kashin-Beck Disease (FSAT-KBD) as well as radiographic findings. RESULTS: All patients were followed for a mean length of 32.47±10.05 months. All force lines in the lower limbs had been improved significantly. No radiographic evidence of loosening or changes in component positioning was observed at the last follow up. The VAS decreased significantly during the first six months after surgery and was maintained until the last follow up (p < 0.01). Similar trends were found in both HSS and FSAT-KBD, which increased significantly post-operatively (p < 0.01). CONCLUSION:Knee arthroplasty can reduce pain and improve function in patients with severe KBD of the knee. Additional studies will be necessary to confirm our findings.
Authors: Elizabeth W Paxton; Ove Furnes; Robert S Namba; Maria C S Inacio; Anne M Fenstad; Leif I Havelin Journal: J Bone Joint Surg Am Date: 2011-12-21 Impact factor: 5.284