PURPOSE To investigate the effect of preoperative coronal tibiofemoral subluxation (CTFS) on functional outcome, prosthesis type, insert thickness and revision rates in patients who underwent total knee arthroplasty (TKA). METHODS A total of 224 knees of 186 patients were included. Patients were divided into two groups as either with (Group 1, 114 knees of 86 patients) or without (Group 2, 124 knees of 100 patients) coronal lateral tibiofemoral subluxation. The mean follow-up period was 71.3 ± 7.3 (range 60-84) months in group 1 and 69.4 ± 6.6 (range 61-79) months in group 2 (n.s.). Coronal tibiofemoral subluxation degree was measured in degrees on standing anteroposterior knee radiographs. Group 1 was divided into three subgroups according to amount of subluxation (< 5 mm, 6-10 mm and > 10 mm). Functional outcome was evaluated using the Western Ontario and McMaster Osteoarthritis Index (WOMAC) score and Knee Injury and Osteoarthritis Outcome Score (KOOS) preoperatively and at the last follow-up visit. Prosthesis type, insert thickness and revision rates were compared between the two groups. RESULTS There were no significant differences between the two groups regarding patient demographics, prosthesis type, and revision rates (n.s.). The insert thickness was found significantly higher in group 1 (p < 0.001). The preoperative and postoperative WOMAC and KOOS scores were found no significantly different between the two groups (n.s.). Among subluxation (+) subgroups, there was no significant difference in functional outcome scores and revision rates (n.s.). However, prosthesis type and insert thickness were significantly associated with the amount of subluxation (p = 0.009 and p = 0.001, respectively). There was no significant correlation between the degree of lower extremity deformity and coronal tibiofemoral amount of subluxation (n.s.). CONCLUSION Preoperative CTFS does not adversely affect the WOMAC score, KOOS and revision rates after TKA. In the clinical practice, surgeons should be aware of the need for a posterior cruciate stabilizing prosthesis and a thicker insert in the presence of CTFS, especially with subluxation greater than 10 mm and to consider a spared bony resection on the tibia in patients suffering from CTFS. LEVEL OF EVIDENCE IV.

中文翻译：

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在全膝关节置换术后，冠状面上的胫股半脱位不影响WOMAC和KOOS。

目的探讨全膝关节置换术（TKA）患者术前冠状胫股半脱位（CTFS）对功能结局，假体类型，插入物厚度和翻修率的影响。方法纳入186例患者的224膝。将患者分为两组，分别为（第1组，共114膝，共86例患者）或无（第2组，共124膝，共100例患者）冠状动脉外侧股骨半脱位。第一组的平均随访时间为71.3±7.3（60-84）个月，而第二组的平均随访时间为69.4±6.6（61-79）（ns）。在站立的前后膝关节X光片上以度数测量冠状胫股半脱位度。根据半脱位量（<5 mm，6-10 mm和> 10 mm）将第1组分为三个亚组。术前和最后一次随访时使用Western Ontario和McMaster骨关节炎指数（WOMAC）评分以及膝关节损伤和骨关节炎结果评分（KOOS）评估功能结局。比较两组的假体类型，插入物厚度和翻修率。结果两组在患者人口统计学，假体类型和翻修率（ns）方面无显着差异。在第1组中发现刀片厚度明显更高（p <0.001）。两组之间的术前和术后WOMAC和KOOS评分均无显着差异（ns）。在半脱位（+）亚组中，功能结局评分和修订率（ns）没有显着差异。然而，假体类型和插入物厚度与半脱位量显着相关（分别为p = 0.009和p = 0.001）。下肢畸形的程度与半脱位的冠状胫股骨量之间无显着相关性。结论术前CTFS不会对TKA后WOMAC评分，KOOS和修订率产生不利影响。在临床实践中，外科医生应意识到在CTFS的情况下，尤其是在半脱位大于10 mm的情况下，需要后十字形稳定假体和较厚的插入物，并考虑对CTFS的患者进行胫骨备用骨切除术。证据级别IV。下肢畸形的程度与半脱位的冠状胫股骨量之间无显着相关性。结论术前CTFS不会对TKA后WOMAC评分，KOOS和修订率产生不利影响。在临床实践中，外科医生应意识到在CTFS的情况下，尤其是在半脱位大于10 mm的情况下，需要后十字形稳定假体和较厚的插入物，并考虑对CTFS的患者进行胫骨备用骨切除术。证据级别IV。下肢畸形的程度与半脱位的冠状胫股骨量之间无显着相关性。结论术前CTFS不会对TKA后WOMAC评分，KOOS和修订率产生不利影响。在临床实践中，外科医生应意识到在CTFS的情况下，尤其是在半脱位大于10 mm的情况下，需要后十字形稳定假体和较厚的插入物，并考虑对CTFS的患者进行胫骨备用骨切除术。证据级别IV。外科医生应意识到在CTFS的情况下，尤其是在半脱位大于10 mm的情况下，需要使用后十字形稳定假体和较厚的插入物，并考虑对患有CTFS的患者进行备用的胫骨骨切除术。证据级别IV。外科医生应意识到在CTFS的情况下，尤其是在半脱位大于10 mm的情况下，需要使用后十字形稳定假体和较厚的插入物，并考虑对患有CTFS的患者进行备用的胫骨骨切除术。证据级别IV。