الفهرس 
I. INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 127 |  |  |
| | | from | 127 | | |
Abstract
Total Knee Arthroplasty (TKA) is the gold standard in the treatment
of symptomatic late-stage osteoarthritis of the knee. Numerous long-term
follow-up studies have reported high clinical success rates of 72– 100% at
10–20 years with reference to pain reduction, functional improvement and
overall patient satisfaction.
The success of TKA depends on several factors, including proper
patient selection, appropriate implant design, correct surgical technique, and
effective post-operative care.
Patellofemoral complications post TKA form a large percentage of all
TKA-related problems and include anterior knee pain, extensor mechanism
injuries and patella fractures, but there is considerable overlap in the
pathologies responsible for anterior knee pain. Evidence has emerged to
suggest that resurfacing reduces anterior knee pain. However, some suggest
that there is no difference in the outcome between the two approaches.
Patellar complications of TKA are fairly common. Despite a decrease
in frequency related to improvements in implant design and surgical
technique, they still account for about 10% of all TKA complications.
The aim of the work is to evaluate Early Patellar related Complications
after TKA so as to study the etiologies, diagnosis and methods of prevention
and treatment.
This Prospective study was conducted on thirty patients who had surgical intervention for TKA at orthopedic surgery department at Menoufia university hospital.
The main results of this study were as follows:
Operative data:
All cases underwent arthroplasty with medial Para patellar approach.
The operative time ranged from 90 minutes to 120 minutes with mean ±SD was 102± 9.791 minutes. The mean ± SD of blood loss was 373.33± 28.57
ml. regarding distal femoral cut rotation, all of them underwent three degree
external rotation and all of they had six degree femoral cut valgus angle.
Clinical data:
1- Hospital stay:
The hospital stay ranged from two days to three days with mean time
(±SD) was 2.2± 0.42 days
2- Flexion Deformity:
Regarding flexion deformity, 30% of patients had preoperative
deformity at 0°-5°, 60% of them at 5°-10° and 10% at 10°-15°. Meanwhile,
most cases (90%) had postoperative deformity at 0°-5° and (10%) at 5°-10°.
There was significant improvement in flexion deformity
3- Range of motion (ROM):
Regarding ROM, most of patients (60%) had preoperative ROM
between 10°-125°, (30%) of them between 5°-125°, and (10%) between 15°-
125°. Meanwhile postoperatively, most cases (90%) had ROM between 0°-
125° and (10%) between 5°-125°. There was significant improvement in
ROM.
4- Leg length discrepancy (LLD):
Preoperative, most of patients (70%) had no LLD because of bilateral
OA knee and 30% of them had shortening because of unilateral OA knee or
had done TKA in the contralateral limb. Meanwhile postoperatively, most
cases (70%) had shortening due to the varus deformity of the contralateral
limb with OA knee and 30% had no LLD.
5- Visual Analog Scale ( VAS ):
The mean preoperative VAS was 7.367 ± 1.217 with range from 6 to
10 while the mean postoperative Score was 1.033 ± 0.795 with range from 0to 2. There was significant decline (improvement) in VAS postoperatively
compared to preoperative (p<0.001).