Comparative Study On The Short-and Medium-term Outcome Of Medial Pivot Prosthesis And Posterior Stabilized Prosthesis With FJS Scale

Objective:To compare the short and medial term clinical efficacy of medial pivot prosthesis(MP)and posterior stabilized prosthesis(PS)in the treatment of knee osteoarthritis,and to apply the Forgotten Joint Score(FJS)scale in the follow-up so as to pay more attention to subjective feelings of the patients.Methods:From September 2012 to September 2014,86 patients received TKA(total knee arthroplasty)in our department of joint surgery was treated with MP prosthesis as MP group and 89 patients with PS prosthesis as PS group.Data was collected by telephone follow-up and out-patient follow-up.Clinical scores including American Knee Society knee score(KSS),range of motion(ROM),WesternOntario and McMaster Universities Osteoarthritis Index(WOMAC),FJS were compared between the two groups.In addition,radiographic results and postoperative complications were also compared.The patients were followed up for 3 month,6 month,1 year and every year after opeation.Results:There was no difference in demographic data between the two groups,of which 142 cases were followed up,33 cases lost followed up,and the data of lost follow-up patients were excluded.In the end,there were 67 cases in MP group and 75 cases in PS group.Mean follow-up periods were 53 ±2.4 months.The clinical score of KSS in MP group increased from 59.0 ±7.2 to 88.9 ±9.2,and the functional score of KSS increased from52.4 ±9.6 to 84.3 ±8.6.The clinical score of KSS in PS group was increased from 58.5±7.1 to 91.0 ±9.7,and the functional score of KSS increased from 53.8±8.5 to 86.6±9.1.The WOMAC score of MP group decreased from 33.9 ±4.9 to 16.0 ±3.7.The WOMAC score of PS group decreased from 33.7 ±6.9 to 15.7 ±4.0.ROM of MP group increased from 110.3 ±15.4 to 127.5 ±14.6.ROM of PS group increased from 109.4 ±15.5 to 126.7±11.6 at the last follow-up.There were no significant differences between the two groups(P > 0.05),especially,the FJS score was 88.6 ±6.2 in MP group and 89.4 ±5.5 in PS group.There were 5 cases in MP group with postoperative complications,on the contrary,2 cases in PS group.The difference was not statistically significant(P > 0.05).All complications were cured.Conclusion:In the aspects of pain relief,functional recovery,especially subjective perception,MP prosthesis and PS prosthesis are roughly the same,and the two kinds of prosthesis do not show any significant difference in clinical outcome.The doctor’s experience and patient’s degree of illness should be considered comprehensively,and combined with the level of the operator and the level of operational proficiency.The subjective feelings of the patients were quantified by using the FJS scale.It provides a reference for doctors to make the clinical decision.Either objective scale or subjective scale has shown obvious advantages.In the future,the comparison of therapeutic effect after TKA should include not only objective evaluation with doctor but also subjective one with patients.Only comprehensive evaluation can ensure that the effect of TKA is not only satisfactory to doctors,but also satisfactory to patients.