| Objective:Analysis of Phase I and stage knee arthroplasty for osteoarthritis patients. Methods:1. Research Methods: this study use a retrospective study.2. The object of study and groups: all patients were from January 2009 to June 2014 in the Second Hospital of Shanxi Medical University received TKR surgery. The study included patients with a total of 110 cases, male 21,female 89; aged 49 to 83 years old, average of 64.32 years old. According to the different surgical methods,patients with osteoarthritis of the knees BTKR divided into three groups: A group for Phase I BTKR under anesthesia; group B for once hospitalization under twice anesthesia; group C for stage BTKR under three times hospitalization. Group B operation interval averaged 7.24±2.46 days; group C operation interval average 7.41±3.26 months. All patients were interviewed for an average follow-up of 29.68 months.3. Data collection: Record the patients’ age, weight index, operative time, blood loss and blood transfusion, postoperative blood loss, hospital stay, hospital costs, and monthly follow-up after surgery 1,3,6,24 and last follow-up, patient records KSS score, range of motion(knees average), the incidence of postoperative complications, and mortality. Results:1. Age of group A was lower than group B and group C, the difference was statistically significant, the age was no statistically significant difference between groups B and C. A, B and C operation between intervals of three groups was statistically significant; among the three groups of sex, weight index, the difference was no statistically significant; preoperative differences between the three groups in the incidence of the disease was statistically significant, the incidence of the complications before the disease of group B was significantly higher than group A, no significant difference between group C complications.2. A, B timing differences, group C patients surgery and tourniquet time was statistically significant, A group was significantly shorter than that in group B and group C surgery time and tourniquet, the difference was statistically significant. No significant difference between group C compared with group B operation time and tourniquet time sum group, p> 0.5, the difference was no statistically significant.3. A group of patients with blood loss knees sum of B, C twice the amount of total knee arthroplasty between hemorrhagic group, p> 0.5, the difference was not statistically significant. A group of two total knee during blood transfusion in patients hospitalized with the same period in group B compares the total amount of blood transfusion surgery, p> 0.5, the difference was no statistically significant. Compared with group C, total blood volume in group A and group B, p <0.5,the difference was statistically significant.4. compared to group B, C,patients hospitalized time of group A, p<0.5, the difference was statistically significant.that I BTKR hospitalization period longer than graded BTKR and staging BTKR significantly reduced. Group B and group C, p>0.5, the difference was no statistically significant, that is, the sum of the total length of hospital stay and hospital stay two installments BTKR group graded TKR no significant difference in hospital stay roughly equal. And B, the total cost of the patients in group C, p <0.5, group A statistically significant difference was that I BTKR hospitalization period compared with the total cost of the total cost of graded BTKR and staging BTKR twice the total cost of hospitalization was significantly shorter. Group B and group C, p <0.5, the difference was statistically significant.5. Three groups of patients were followed up last KSS knee score, knee-degree difference was no statistically significant. Three groups were at last follow-up were not statistically significant.6. Early complications, including deep vein thrombosis, hematoma and incision events, late complications including periprosthetic infection and aseptic loosening and death. Groups the incidence of deep vein thrombosis, hematoma incidence incision event, the difference periprosthetic infection was no statistically significant, aseptic loosening of cases did not occur. The total complication rate was significantly higher than the same period BTKR staging BTKR group, the difference was statistically significant. Conclusion:1.advantage of Phase I of bilateral total knee arthroplasty(BTKR) are as follows: single anesthe-sia, surgery time is short, efficacy and patient satisfaction is relatively high, and the cost of surgery decreased compared with surgical staging.2. drawbacks of Phase I of bilateral total knee arthroplasty(BTKR) are as follows:postoperative complicati-onns, increased risk of cardiovascular complications, wound infection potential increases, while increasing the amount of blood loss and allogeneic blood transfusion. |
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