Study On The Correlation Between The Degree Of Joint Space Stenosis Before Operation And The Early Clinical Efficacy In Patients With Total Knee Arthroplasty

Objective:To investigate the effect of knee joint space stenosis degree on knee joint osteoarthritis patients’ preoperative imaging on early clinical outcomes after total knee arthroplasty(TKA),and to analyze the degree of knee joint space stenosis and operation Correlation between improvement in knee function and pain in post-patients.This helps clinicians to screen out patients who are more suitable for total knee arthroplasty according to the degree of knee joint space stenosis in preoperative imaging,giving patients more accurate psychological expectations of postoperative efficacy,and improving satisfaction.Materials and Methods: The clinical data of 121 patients undergoing total knee arthroplasty for knee osteoarthritis at Hospital of Dalian Medical University from September 2017 to June 2019 were collected.According to the inclusion and exclusion criteria,16 patients were excluded.A total of 105 patients who underwent the first total knee arthroplasty were included in this study.Among them,54 cases were in the joint space stricture group and 51 cases were incompletely narrowed group.Statistical analysis was performed on relevant intraoperative and postoperative indicators that met the inclusion criteria.Comparative indicators include: operation time,intraoperative bleeding,preoperative and postoperative hemoglobin changes,incision drainage,blood transfusion rate,incision healing,preoperative and postoperative visual analogue score(VAS pain score)and their changes,The improvement of knee joint mobility after operation,KSS function score and its change before and after operation.All data were statistically processed using SPSS23.0 software.T-test for measurement data and 2 testfor counting data.After excluding irrelevant factors,the Spearman method was used to test the correlation between the degree of knee stenosis and the changes in knee joint VAS pain score,mobility,and KSS function score(P <0.05 was considered statistically significant)Results:A total of 105 patients in both groups were subjected to preoperative data statistics and postoperative follow-up.Follow-up results showed that except for 10 cases of incision fat liquefaction leading to delayed healing,1 case of suspected knee joint infection(healed),1 case of calf muscle vein thrombosis,and 1 case of unexplained knee swelling after surgery,no periprosthesis occurred Serious complications such as fractures,severe knee stiffness,and nerve damage.There was no significant difference in the operation time,intraoperative blood loss,postoperative blood transfusion,preoperative and postoperative hemoglobin difference,postoperative drainage volume,wound healing status and hospital stay(P>0.05).The difference in preoperative VAS pain score,preoperative knee joint mobility,and preoperative American Knee Joint Association functional score(KSS functional score)between the two groups were statistically significant(P<0.05).There was no significant difference in postoperative VAS pain score,postoperative knee joint mobility,and postoperative American Knee Joint Association functional score(KSS functional score)between the two groups(P>0.05).In terms of VAS pain scores,patients in the complete stenosis group were reduced from preoperative(7.43±1.14)points to postoperative(2.50±0.72)points,and patients in the incomplete stenosis group were reduced from preoperative(6.11±1.11)points to postoperative(2.50 ±0.78)points,the difference was statistically significant(P<0.05);the average reduction of patients in the complete stenosis group was(4.94±1.09)points,and the average reduction of the incomplete stenosis group was(3.63±0.84)points,the difference was statistically significant(P <0.05).In terms of knee mobility,the complete stenosis group increased from preoperative(88.98±16.86)°to postoperative(128.53±7.44)°,and the incomplete stenosis group increased from preoperative(97.84±17.50)° to postoperative(129.78± 8.48)°,statistically significant(P<0.05);the average increase in patients with complete stenosis group was(39.72±16.76)°,and the average increase in incomplete stenosis group was(31.90±17.29)°,the difference was statistically significant(P<0.05).In terms of knee KSS function score,patients in the complete stenosis group improved from preoperative(37.88±4.92)points to postoperative(86.07±4.47)points,and patients in the incomplete stenosis group improved their VAS pain score from preoperative(41.98±6.99)points.By postoperative(86.03±3.61)points,the difference was statistically significant(P<0.05);among them,the average improvement of patients in the complete stenosis group was(48.01±5.09)points,and the average improvement of the incomplete stenosis group was(43.98±6.67)points,the difference It is statistically significant(P<0.05).In addition,there was a significant negative correlation between the degree of stenosis of the knee joint space before surgery and the degree of improvement in the postoperative VAS pain score,the degree of improvement in knee mobility,and the improvement in the postoperative knee KSS function score(VAS pain score: r=-0.431 P<0.05;KSS function score: r=-0.228 P<0.05;activity level: r=-0.362P<0.05).Conclusion:There was a significant negative correlation between the degree of knee joint space stenosis before surgery and the degree of improvement of postoperative VAS pain score,knee joint mobility and postoperative knee KSS function score.That is,the narrower the knee joint space before surgery,the higher the degree of improvement in knee function,mobility and pain of postoperative patients.