Results of knee osteoarthri̇ti̇s treatment wi̇th cemented total artroplasty

This study investigated knee joint anatomy biomechanics, the characteristics and varieties of knee prostheses and surgical techniques and complications and follow-up results of patients undergoing cemented total knee prosthesis surgery in our clinic. One hundred two knees of 88 patients undergoing cemented total knee prosthesis surgery at the Recep Tayyip Erdoğan University Education and Research Orthopedic and Traumatology Clinic were enrolled. These were assessed using the Knee Society clinical and radiological rating system and a visual analogue scale. Mean age at time of surgery was 68.86±6.41 years. Mean body mass index was 35.68±6.08 kg/m 2. Thirty-nine patients (44.3%) underwent surgery to the left knee, 35 (39.8%) to the right knee and 14 (15.9%) to both. Anterior knee pain was present in 25 patients (24.5%) but not in 77 (75.5%). Total tibial loosening was identified in one patient. Revision arthroplasty was performed. Mean length of hospitalization was 11.87±3.26 days. Mean level of blood transfusion was 2.23±1.20 units. Mean duration of surgery was 135.09±37.27 min. Mean length of tourniquet use during surgery was 77.47±23.71 min. Mean insert thickness was 11.43±1.98 mm. Mean postoperative monitoring time was 32.82±14.01 months. The most common acute complication was superficial infection, in 20 patients. Antibiotherapy was sufficient in 18 patients, while would debridement and closure under anesthesia were performed on two patients. No deep infection or septic loosening was determined. Knee dislocation occurred in one patient in the early postoperative period. Achilloplasty was performed on a patient with tension in the Achilles tendon. The femoral stem was revised. Deep vein thrombosis developed after surgery in one patient. This subsided with treatment. Patellar tendon rupture occurred in one patient in the 1st month postoperatively. Tenodesis was applied. Femoral neck stress fracture was determined in one patient in the 2nd month postoperatively. This was treated with partial hip prosthesis. Mean preoperative knee score was 29.15±10.63, compared to 85.90±6.25 postoperatively. Mean preoperative functional score was 32.38±20.35, compared to a mean postoperative functional score of 83.91±18.54. During follow-up, perfect results based on knee scores were achieved in 63 knees and good results in 38. In terms of functional scores, we achieved perfect outcomes in 65 knees, good in 16, moderate in 10 and poor in 10. In other words, based on knee scoring we achieved 100% perfect and good outcomes, while based on functional scores we achieved 79.4% perfect and good outcomes. Considering all our cases together, we obtained perfect and good results in 89.5%. Our patients' mean preoperative visual analogue score was 9.05±0.876, compared to 1.07±1.25 postoperatively. In conclusion, satisfactory functional results with low complication levels can be achieved with the right patient, appropriate implants and an experienced team. Key words: Total knee arthroplasty, knee osteoarthritis, knee joint, cemented total knee, knee pain.