A Study Of The Effect Of Abrasion Arthroplasty For Treatment Of Osteoarthrosis Of The Knee Goint:

Shawky El Eraky Mustafa

In this study we have discussed the histology of adult articular cartilage, pathology, aetiology, clinical picture, anddiagnosis of osteoarthrosis. Different lines of treatment werementioned, which included conservative and surgical lines.The surgical options for gonarthrosis are upper tibialosteotomy, joint debridement, unicompartmental kneereplacement, total knee replacement, abrasion arthroplasty,upper tibial osteotomy and abrasion arthroplasty, corticaldrilling and cortical drilling in conjunction with upper tibialosteotomy.We studied the results of abrasion arthroplasty on 41patients, 36 were finally followed’ up with a mean age of 56years. Mean follow up period was 18 months. 72.2% of patientsshowed satisfactory results. The best results were obtained inthe following patient a normal weight, aged from 40-50 yearsold, grade IV gonarthrosis, accompanied by high tibialosteotomy and postoperative use of CPM. Rate of success insuch patient reaches 85% or higher.Postoperative mean range of motion was (0-128 degrees).This operation allows the patient with grade IV to move hisknee nearly fully, to squat, to kneel, and to sit on the floorwhich are very important daily activities of oriental people,for whom we recommend this procedure as the main surgicalline of treatment rather than total knee replacement, whichdoes not reach the same functional result.Abrasion arthroplasty is a satisfactory procedure formanagement of grade IV gonarthrosis which provides thepatient with a good range of motion nearly full, which is veryimportant in the daily life of the oriental people.Postoperative CPM is preferable and this improves theresult, relieves pain and accelerates achieving full flexion.Every effort should be taken to reduce the weight prior tosurgery as the results worsen by overweight. In degenerativearthritis with genu varum the overall result improves to agreat extent by addition of high tibial osteotomy and such aprocedure can be performed either in the same cession or canbe delayed. Range of motion after abrasion arthroplasty isbetter than after total knee replacement, and this is highlyimportant in the daily activity of oriental people.Following the statistical analysis using Z test, the overallresults proved to be highly significant. The result of the agegroups from (40-50 years), (50-60 years) and (70-80 years) weresignificant, while less than 40 years and (60-70 years) were notsignificant. Difference in weight and sex did not affect theresults significantly.Postoperative mobilisation gave highly significant results.The results of abrasion arthroplasty combined with HTO weresignificant.