[An analysis of operation-correlated complications of total knee arthroplasty].

OBJECTIVE: To summarize and analyze the operation-correlated complications of total knee arthroplasty (TKA) with posterior stabilized prosthesis (PS).

METHODS: From October 2000 to October 2007, 707 cases (816 knees) underwent TKA. All the TKA knees were divided equally into former and latter groups according to the operation time (408 knees for each group). In the former group (October 2000 to January 2005, n=350), there were 63 males (84 knees) and 287 females (324 knees), aging (63.5 +/- 7.8) years. A total of 198 left knees affected and 210 right knees affected; 292 single knees affected and 58 both knees affected. There were 304 knees of osteoarthritis, 84 knees of rheumatoid arthritis and 20 knees of other disease. The disease course was (9.3 +/- 5.6) years. The knee range of motion (ROM) was (97.2 +/- 8.7) degrees, the HSS score was 47.4 +/- 12.2. In the latter group (January 2005 to October 2007, n=357), there were 77 males (92 knees) and 280 females (316 knees), aging (62.7 +/- 6.3) years. A total of 221 left knees affected and 187 right knees affected; 306 single knees affected and 51 both knees affected. There were 278 knees of osteoarthritis, 109 knees of rheumatoid arthritis and 21 knees of other disease. The disease course was (8.6 +/- 5.1) years. The knee ROM was (101.1 +/- 10.3) degrees, the HSS score was 49.3 +/- 11.2. We modified the method of lateral patellar retinaculum release and used a new femoral rotational alignment technique in the latter group. The intraoperative and postoperative complications were divided into mild, moderate and severe. The HSS score, ROM and complications of the knee were compared and analyzed statistically during the follow-up.

RESULTS: The former group was followed up 5.3 years (1 to 7 years), complications occurred in 278 knees (68.1%), including mild in 136 knees (33.3%), moderate in 135 knees (33.1%) and severe in 7 knees (1.7%). The latter group was followed up 2.1 years (0.5 to 3.5 years), complications occurred in 159 knees (39.0%), including mild in 111 knees (27.2%), moderate in 47 knees (11.5%) and severe in 1 knee (0.2%), and there was significant difference between them (P < 0.001). There was significant difference in increased ROM between the former group (6.0 +/- 3.7) degrees and the latter group (14.4 +/- 4.2) degrees after operation (P < 0.05). There was significant difference in increased HSS score between the former group (36.9 +/- 3.7) and the latter group (44.0 +/- 4.2) after operation (P < 0.05).

CONCLUSION: The TKA is a complex operation with innumerable potential complications. To accumulate operative experience and improve surgical skills are the key points to reduce the operation-correlated complications.