| Objective: Compare the clinical efficacy and advantages or disadvantages between the standard and high-flexion prosthesis in TKA.Methods: In this paper,we use a retrospective study approach.All the patients from march 2012 to July 2014 in the department of bone and joint of the Second Hospital of Shanxi Medical University,who were surgeried by unilateral or simultaneous bilateral TKA for the first time were followed up.The study included patients with a number of 91(103 knees).We grouped them to the high-flexion group(50 knees)and standard group(53 knees)according to the prosthesis types(prosthesis were from American company Smith & Nephew).According to various times before and during follow-up segment and the last follow-up systematic and scientific Evaluation indicators including: KSS score,WOMAC,SF-36 scale,ROM,image data of knee joint after operation,and self-evaluation from the patients.Then we analyzed the satisfaction of the patients and we summarized and researched the postoperative complications.We use SPASS13.0 to process the data and derive the statistical evidence.Results: In the 91 patients were followed up,the average course of follow-up time is 15 months(13 months to 28 months),postoperative KSS score,WOMAC score,ROM and self-satisfaction were significantly higher than the preoperative evaluation,postoperative pain were significantly ligten.The difference between the high-flexion and the standard prosthesis group study:(1)KSS score will be used as a major assessment.We compare the KSS,WOMAC between the two groups(functional score).While P> 0.05,the difference was not statistically significant.The range of motion of the last follow-up and maximum flexion between the two groups,while P> 0.05(no statistical significance);but compare the results(38 knee last follow-up)that preoperative range of motion can reach 110 °,the high-flexion group of 18 knees joint activity 123.39 °(0 ~ 128 °),the maximum flexion was 124.66 °(120 ~ 128 °),the standard set of 20 knees is115.02 °(0 ~ 120 °),the maximum flexion 116.12 °(110 ~ 120 °),that it would 38 high knee flexion postoperative knee flexion and maximum are better than the standard group;(2)Wherein the VAS scalein the high-flexion group was 2.02 ± 1.24 points(WOMAC pain score1.02 ± 1.29),standard group was 3.11 ± 1.42 points(WOMAC pain score3.93 ± 1.79)between the two P <0.05,the difference was statistically significant,that is,pain relief high-flexion group than the standard group.The results in the patient self-satisfaction,the total of the SF-36 self-assessment between the two groups,P <0.05(significant difference),that is after the high-flexion group were higher than the standard set of self-satisfaction,especially physical health in part satisfaction higher.(3)No significant differences in postoperative complications between standard and high-flexion group,strict control of risk factors in this study,none of infection,one case of DVT occurred in the high-flexion group,the standard group 2 cases;postoperative follow-up found in the standard group one case of asymptomatic bright X-ray,the late follow-up did not show any signs of loosening of the prosthesis;high incidence of postoperative pain standard group;Conclusion: High-flexion prosthesis is becoming more and more extensive in the clinical application as a stabilizing prosthesis designed by a larger activity in order to meet the different needs of patients.In the study,we found that the general efficacy has been improved when we use of high-flexion prosthesis,especially those with goodpreoperative knee joint after surgery using high-flexion prosthesis can be recovered better,knee function can be obtained more big knee motion,and the incidence of anterior knee pain is alleviated.No significant differences in postoperative complications between standard and high-flexion group.Therefore,to fully understand and master the preoperative range of flexion,a comprehensive assessment of soft tissue and joint function,and select good match knees prosthesis and intraoperative precise balance is an important factor in successful operation.Short for patients with special needs or requirements for higher after a high-flexion prosthesis is also a good choice,High-flexion prosthesis long-term clinical efficacy of long-term follow-up needs further study. |
