Changes Of Biochemical Indexes And Study Of Early Curative Effect In The Patients With Rheumatoid Arthritis After Total Knee Arthroplasty

Objective:To explore the changes of biochemical indexes and the early curative effect in the patients with middle-late rheumatoid arthritis after total knee arthroplasty.Methods:In this study,we choose 30 patients in Shandong province traditional medicine hospital joint line after middle-late rheumatoid arthritis of total knee arthroplasty as the research object which in strict accordance with the excluding standard screening from October 2013-October 2015.Experiments adopt its own control method,the detection of preoperative rheumatoid factor and C reactive protein and blood sedimentation and related data,observation records preoperative American Hospital for special surgery in patients with knee rating(at the for special surgery knee scores,HSS)results and mobility(Range of motion,ROM);Outpatients care when testing related biochemical indicators,postoperative observation records HSS scores and ROM.Using statistic method to study biochemical indicators of change and the knee joint function after surgery for patients with preoperative changes.Results:Rheumatoid factor was 305.57±128.70 before treatment,postoperative follow-up was 274.71±95.53 at the end of the time,there was statistically difference(P<0.05);Preoperative C-reactive protein was 46.76±29.50,postoperative follow-up was 35.47±20.87 at the end of the time, there was statistically difference( P <0.05);Preoperative blood sedimentation was69.20±26.99,postoperative follow-up was 55.63±19.95 at the end of the time,there was statistically difference(P<0.05).Preoperative risk of knee for HSS score points were 40.86±14.28,10 days after for HSS score points were 73.92±6.83, both statistically significant( P < 0.05);For HSS score 10 days postoperatively was 73.92±6.83,the last follow-up HSS score was 85.81±4.90,there was statistically difference(P<0.05).Preoperative risk of knee average ROM was 71.31°,an average of 10 days postoperatively ROM was 91.29°,there was statistically difference(P<0.05);An average of 10 days postoperatively ROM was 91.29°,average at the time of the follow-up ROM 106.11°,there was statistically difference(P<0.05).According to the HSS scoring to assess efficacy:excellent 28 cases,nice 6 cases,passable 3 cases,the excellent and good rate was 91.9%.Postoperative seventh day,there were 1 case of pulmonary infection in patients with respiratory cured and 2 cases with blade delayed union.Under active treatment and delaying stitches,it does not appear other recent complication.Outpatient follow-up of X ray film prosthesis position is good,no signs of the dislocation of patella trajectory,did not see bright zone around implants,no complication.Conclusion: At the end of the TKA surgery outpatient follow-up rheumatoid factor, blood sedimentation and C- reactive protein levels were reduced than before, rheumatoid activity to get a degree of control.The early therapeutic effect of total knee replacement in the treatment of RA is worth affirmation, and follow-up in the near future to further improve the knee joint function.Through standardizing the orthopedic surgeons sufficient preoperative preparation, surgical operation, all aspects of the prevention and treatment of postoperative, can reduce the risk of surgical complications.