Knee Arthroplasty in Patients With Poliomyelitis and Extensor Mechanism Deficiency. Review and Experience in Nine Cases

Main Article Content

Fernando González Morán

Abstract

Objectives: To report the clinical and functional outcomes of patients affected with post-polio syndrome treated with total knee arthroplasty, evaluating whether the choice of the prosthesis is conditioned by the quadriceps functional deficit.
Materials and Methods: patients with post-polio syndrome were evaluated in their muscle deficit condition and with functional tests such as the 10-meter walk test, 2-minute walk test and timed up and go test, as well as Knee Society Score preoperatively and 1 year after knee arthroplasty.
Results: All patients significantly improved functional values that directly impacted their quality of life. The Knee Society Score did not present significant differences between the most severe cases with quadriceps deficit with recurvatum and those with less involvement, but the functional tests did show a significant difference between these subgroups.
Conclusions: Total knee arthroplasty is a valid treatment alternative in this complex pathology, providing the patient with pain relief, recovery of function and improving their quality of life. The restoration of stability through constrained prosthetic designs is a key factor in the recovery of a functional gait pattern in patients with recurvatum. Patients with quadriceps strength who overcome the resistance of gravity have functional outcomes comparable to those of patients without post-polio syndrome and do not require hinged prostheses.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Article Details

How to Cite
González Morán, F. (2022). Knee Arthroplasty in Patients With Poliomyelitis and Extensor Mechanism Deficiency. Review and Experience in Nine Cases. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(5), 667-675. https://doi.org/10.15417/issn.1852-7434.2022.87.5.1646
Section
Clinical Research
Author Biography

Fernando González Morán, Orthopedics and Traumatology Service, Sanatorio Mater Dei, Autonomous City of Buenos Aires, Argentina

Orthopedics and Traumatology Service, Sanatorio Mater Dei, Autonomous City of Buenos Aires, Argentina

References

1. Agüero AL. Poliomielitis en Argentina: Epidemias, políticas sanitarias, tratamientos e instituciones. Rev Argent
Salud Pública 2020;12:e21. Disponible en: https://rasp.msal.gov.ar/index.php/rasp/article/view/673/646

2. Portnoy S, Schwartz I. Gait characteristics of post-poliomyelitis patients: Standardization of quantitative data
reporting. Ann Phys Rehabil Med 2013;56(7-8):527-41. https://10.1016/j.rehab.2013.06.005

3. Gan ZWJ, Pang HN. Outcomes of total knee arthroplasty in patients with poliomyelitis. J Arthroplasty 2016;31(11):2508-13. https://doi.org/10.1016/j.arth.2016.04.019

4. Rahman J, Hanna SA, Kayani B, Miles J, Pollock RC, Skinner JA, et al. Custom rotating hinge total knee
arthroplasty in patients with poliomyelitis affected limbs. Int Orthop 2015;39(5):833-8. https://doi.org/10.1007/s00264-014-2572-y

5. Stolwijk-Swüste JM, Beelen A, Lankhorst GJ, Nollet F, CARPA studying group. SF36 physical functioning scale
and 2 minute walk test advocated as core qualifiers to evaluate physical functioning in patients with late-onset
sequelae of poliomyelitis. J Rehabil Med 2008;40(5):387-92. https://doi.org/10.2340/16501977-0188

6. Giori NJ, Lewallen DG. Total knee arthroplasty in limbs affected by poliomyelitis. J Bone Joint Surg Am 2002;84(7):1157-61. https://doi.org/10.2106/00004623-200207000-00010

7. Jordan L, Kligman M, Sculco TP. Total knee arthroplasty in patients with poliomyelitis. J Arthroplasty 2007;22(4):543-8. https://doi.org/10.1016/j.arth.2006.03.013

8. Prasad A, Donovan R, Ramachandran M, Dawson-Bowling S, Millington S, Bhumbra R, et al. Outcome of total
knee arthroplasty in patients with poliomyelitis: A systematic review. EFORT Open Rev 2018;3(6):358-62.
https://doi.org/10.1302/2058-5241.3.170028

9. Pomeroy E, Fenelon C, Murphy EP, Staunton PF, Rowan FE, Cleary MS. A systematic review of total knee
arthroplasty in neurologic conditions: Survivorship, complications, and surgical considerations. J Arthroplasty
2020;35(11):3383-92. https://doi.org/10.1016/j.arth.2020.08.008