| Objective The osteotomy was performed by investigating the actual value of femoral valgus angle and femoral external rotation angle measured by preoperative radiograph and computed tomography(CT)based on the results of total knee arthroplasty with valgus angle of 5° and external rotation angle of 3° in total knee arthroplasty.Differences in postoperative knee HSS scores to understand the clinical value of preoperative imaging measurements in the recovery of knee joint function after total knee arthroplasty,and to explore the clinical efficacy of both clinical efficacy grades in total knee arthroplasty.How to reasonably select the valgus angle of the femur and the external rotation of the femur to improve the efficacy of TKA.Methods 100 patients with knee osteoarthritis admitted to the Affiliated Hospital of Qingdao University from October 2015 to October 2016 were analysed.All patients had no apparent history of trauma.The first total knee arthroplasty was performed.The diagnosis was confirmed as knee osteoarthritis,and both knees were inversion.There was no serious deformity in the knee joint.Excluding postoperative infection,trauma and other nontechnical reasons required revision,serious systemic diseases and neuromuscular disorders affecting activities.Those who died,and who could not complete the assessment,were all treated by an experienced senior doctor.The 100 patients were randomly divided into two groups: conventional osteotomy group(conventional group)and measurement osteotomy group(measurement group).In the conventional group,the femoral valgus angle was 5° and the valgus angle was 3° osteotomy.The CT and knee joints of the lower extremities were measured preoperatively in the measurement group.Auto CAD software was used to measure and record the femoral external rotation and femoral ectropion.Angle,according to the measured value of osteotomy,postoperative HSS score criteria were used in both groups,the patient’s postoperative recovery at 6 weeks and 3 months after follow-up,collect relevant data and statistical analysis,compare the two groups of surgery Efficacy.Results All 100 patients were followed up.The follow-up rate was 100%.The followup time was 6 weeks and 3 months.The follow-up subjects were the patients themselves.The HSS scores of the two groups were tested by independent sample t test(α=0.05),t=3.2438 at 6 weeks,p=0.004974 <0.05;t=3.1024 at 3 months,p=0.002513 <0.05.Differences in HSS scores between the two groups Statistically significant,and the overall score of the measurement group was higher than that of the conventional group.The clinical scores and functional scores of the two groups at 6 weeks and 3 months were compared and analyzed respectively.The clinical scores of the two groups could be t-tested to obtain t=5.71,P<0.01;t=5.49,P<0.01.There are significant differences.Functional scores between the two groups could be t-tested with t=4.37,P<0.01;t=4.28,P<0.01.There was significant difference between the two groups.The χ2 test between the two groups yielded χ2=4.26,P=0.036,P<0.05.There was significant difference between the two groups in the good rate,and the measurement group was dominant.During the operation,the passive buckling knee joint exercise was used to evaluate the effect of the sacral trajectory after the placement of the prosthesis in the two groups of patients.The routine group was good in 38 cases,generally in 12 cases,and the excellent and good rate was 76%;the measurement group was good in 46 cases and generally in 4 cases,and the excellent rate was good.92%.The ROM of knee joint activity was compared between 6 weeks and 3 months after operation.The excellent and good rate was 16% at 6th week and 28% at 3 months in the conventional group.The excellent and good rate was 24% at the 6th week and 46% at 3 months in the measurement group.Conclusion Preoperative imaging measurements can accurately determine the actual size of the valgus and external rotation angle of the femur,and individualized design.The method is simple,effective,and reproducible.Strict control of the indications Choosing the right knee osteoarthritis patients,controlling the position of the radiography,and using accurate measurement methods to obtain more accurate femoral valgus angle and external rotation of the femur to guide the osteotomy compared to the conventional femur Patients with TKA with 5° external rotation and 3° osteotomy of external rotation had higher scores,fewer postoperative complications,and patient’s pain level,walking function,flexion activity,muscle strength,flexion deformity,stability On the whole,it is even more dominant and clinical function recovery is also more ideal. |
