1. Department of Joint Surgery, Senior Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China; 2. Department of Orthopedic, the Eighth Medical Center of Chinese PLA General Hospital, Beijing 100091, China; 3. Sichuan Rangtang County People's Hospital, Aba 624300, China; 4. Hebei North University, Zhangjiakou 075132, China
Abstract：Objective To investigate the short-term clinical effect of total knee arthroplasty in the treatment of Kashin-Beck disease (KBD) of the knee in Ramtang area.Methods A retrospective analysis was performed on 88 patients with KBD (32 males and 56 females) aged from 34 to 67 years, with an average age of (53.57±10.40) years, who were admitted to the Department of Orthopedics of Rangtang County People’s Hospital of Sichuan Province from January 2017 to September 2019. There were 35 cases of stage I and 53 cases of stage II. All the patients with KBD were treated with total knee arthroplasty for the first time. Before operation and at 1, 3, 6, 12 and 36 months after the operation, the pain severity of the knee joint were evaluated by visual analogue scale (VAS) and the knee society knee score (KSS). The hospital for special surgery knee score (HSS score) systematically evaluated the knee function, the SF-36 score evaluated the quality of life, and the ROM of the knee joint was measured. Before treatment and at the last follow-up, the full-length X-ray films of both lower limbs were taken to measure the hip knee ankle angle and tibiofemoral angle to assess the lower limb force line.Results The patients were followed up for 36 to 54 months, with an average of (39.85±6.89) months. VAS pain score, HSS clinical score, KSS function score, SF-36 score, physiological function, physical pain, vitality, social function, emotional function, and mental health score were improved. The lower limb force line hip knee ankle angle (HKA) and ROM were improved (P<0.05).Conclusions The patients with KBD in stage Ⅰ and stage Ⅱ at high altitude can correct the lower limb force line, relieve the knee joint pain and improve the joint function after the first artificial joint replacement, which is worthy of clinical promotion.
Mathieu F, Begaux F, Suetens C, et al. Anthropometry and clinical features of Kashin-Beck disease in central Tibet [J]. Int Orthop, 2001, 25(3):138-141.
[2]
Li Y, Zhou Z, Shen B, et al. Clinical features of Kashin-Beck disease in adults younger than 50 years of age during a low incidence period: severe elbow and knee lesions [J]. Clin Rheumatol, 2013, 32(3):317-324.
[3]
Hinsenkamp M. Kashin-Beck disease[J]. Int Orthop, 2001,25(3):133.
Liu H M, Wang Y F, Wu J M, et al. A comparative study of clinical effect of total knee arthroplasty in the treatment of primary osteoarthritis and osteoarthritis of Kashin-Beck disease[J]. Int Orthop, 2020,44(9):1719-1726.
[6]
Tang X, Zhou Z K, Shen B, et al. Total knee arthroplasty in elderly patients with severe Kashin-Beck disease of the knee[J].Int Orthop, 2014,38(4):753-759.
Liu J T, Guo X, Ma W J, et al. Mitochondrial function is altered in articular chondrocytes of an endemic osteoarthritis, Kashin-Beck disease[J]. Osteoarthritis Cartilage, 2010, 18(9): 1218- 1226.
Luo R, Liu G, Liu W, et al. Efficacy of celecoxib, meloxicam and paracetamol in elderly Kashin-Beck disease (KBD) patients[J]. Int Orthop, 2011,35(9):1409-1414.
[13]
Yang P, Guo X, He X, et al. The efficacy and safety of intra-articular injection of hyaluronic acid in the knee and physical therapy agents to treat Kashin-Beck disease: a prospective interventional study[J]. Exp Ther Med, 2016 ,12(2):739-745.
Giesinger J M, Hamilton D F, Jost B, et al. WOMAC, EQ-5D and knee society score thresholds for treatment success after total knee arthroplasty[J]. J Arthroplasty, 2015, 30(12): 2154-2158. .
[19]
Ling M, Wu X, Chang Y, et al. Staged total knee arthroplasty for bilateral complex knee deformities from Kashin-Beck disease and skeletal dysplasia[J]. Knee,2017,24(3):692-698.
[20]
Jin Z K, Yang Y, Xu C X, et al. Outcomes of total knee arthroplasty in the adult Kashin-Beck disease with severe osteoarthritis[J]. Int Orthop, 2019,43(2):323-331.
[21]
Huang Q, Zhou Z K, Ma J, et al. The arthropathic and functional impairment features of adult Kashin-Beck disease patients in Aba Tibetan area in China[J]. Osteoarthritis Cartilage, 2015, 23(4):601-606.
2023, Vol. 34 
