Остаточная деформация после двустороннего эндопротезирования коленных суставов: влияние на краткосрочные результаты

Purpose - to evaluate the impact of frontal positioning of prosthesis components after bilateral TKA on short term functional outcomes. Material and methods. The authors performed a retrospective analysis of teleroentgenograms of 466 patients after bilateral TKA with initial varus deformity. Functional and roentgenological outcomes were evaluated at average in 16,4±2,9 months postoperatively. Mean preoperative varus deformity was 10° (from 5 to 25°), initial angle between the anatomical and mechanical femoral axis (FVA) was 6,7±2° (from 3 to 12°). The neutral axis of both lower limbs (HKA = 180±0,5°) was obtained in 99 (21,2%) out of 466 patients. Residual deformity in one of the limbs above 3° with the neutral alignment of the contralateral limb was observed in 44 (9,4%) patients, bilateral residual deformity - in 32 (6,9%) patients. Other 291 patients demonstrated the deviation from mechanical axis in the range from 1 to 3° (±0,5°). All patients were divided into three groups: first group consisted of 10 patients with neutral axis of one limb and varus deformity of the other limb above 3°; second group - 10 patients with bilateral residual varus deformity above 3°; third group - 12 patients with neutral axis of both limbs (HKA = 180°). The angle of residual deformity averaged 3,7° (from 3,2 to 5,1°). Results. No statistically significant differences between the groups were observed for dynamometric parameters and SF-36 scores, as well as for functional KSS scores ( p >0,05). However, the authors reported in patients of the first group a stance phase on the side of residual varus deformity longer at 15% ( p 0,05). Однако у пациентов 1-й группы на стороне остаточной варусной деформации отмечено увеличение периода опоры на 15% ( p <0,05) и уменьшение периода переноса на 17% ( p