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Published on: July 22, 2021
Total knee arthroplasty in limbs affected by poliomyelitis
Nicholas J Giori1, David G Lewallen
1Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MI 55905, USA.
The Journal of Bone and Joint Surgery. American Volume
|July 11, 2002
Summary
Total knee arthroplasty improved pain scores in polio patients with adequate quadriceps strength, but functional outcomes varied. Complications like instability are possible, especially in severely affected knees.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
Background:
- Poliomyelitis can lead to severe knee degeneration, necessitating surgical intervention.
- Limited data exists on total knee arthroplasty outcomes in polio-affected limbs.
Purpose of the Study:
- To evaluate the results and complications of total knee arthroplasty (TKA) in patients with a history of poliomyelitis.
- To assess the impact of preoperative quadriceps strength on TKA outcomes in this population.
Main Methods:
- Retrospective review of 16 TKAs in 15 polio patients (1970-2000).
- Analysis of patient charts and radiographs, with follow-up for a minimum of two years for most patients.
Main Results:
- Complications included periprosthetic fractures, nerve palsy, patellar tendon avulsion, and recurrent instability, linked to poor bone quality and soft tissue issues.
- Knee Society pain and knee scores improved in patients with antigravity quadriceps strength.
- Functional scores showed limited improvement or deterioration in many patients, regardless of preoperative strength.
Conclusions:
- TKA can improve pain in polio patients with sufficient quadriceps strength.
- Functional outcomes are less predictable, with potential for instability and deterioration, particularly in severely affected knees.
