| Objective:In order to provide theoretical basis for the choice of alignment in total knee arthroplasty,we compared the early outcome of kinematic alignment(KA)and mechanical alignment(MA)techniques in total knee arthroplasty(TKA).Methods:The data of patients who underwent total knee arthroplasty in Northern Jiangsu People's hospital from January 2019 to June 2019 were collected.According to different alignment techniques used during the operation,they were divided into kinematic alignment technique group(KA group)and mechanical alignment technique group(MA group).The patients were regularly reviewed was performed at 1,3,and 6months after operation.The operation time and operative blood loss,postoperatively and preoperatively 1,3,and 6 months range of motion of knee,VAS score,HSS score,WOMAC score,radiographic outcomes and so on were compared between the two group.SPSS 19.0 software was used to analyze the data.P<0.05 was indicated that the difference was statistically significant.Results:According to the set grouping criteria,a total of 59 patients(59 knees)were included.The average follow-up time was 9.2 months.Among them,28 patients(28 knees)in the KA group,6 males(6 knees),and 22 females(22 knees),an average age of 65.29±6.79 years,BMI of 26.89±3.00 kg/m~2;31 patients(31 knees)in the MA group,10 males(10 knees),21 females(21 knees),and an average age of 68.52±7.98years old,BMI was 27.01±2.88kg/m~2.There were no significant differences in gender,age,and BMI between the two groups(P>0.05).There were no significant differences in range of motion of knee,VAS score,HSS score,and WOMAC score between the two groups before operation(P>0.05).The knee flexion and extension function of the two groups was improved,and the pain was significantly reduced.The range of motion of knee,VAS score,HSS score,and WOMAC score were better than those before operation in each time period after operation(P<0.01).The operation time in the KA group was longer than that in the MA group.The average operation time in the KA group was 118.57±31.64 min,and the average operation time in the MA group was 94.48±32.82 min.There was a statistically significant difference between the two groups(P=0.01).Compared with the two groups,there was no significant difference in operative blood loss(P>0.05).The range of motion of knee of the KA group was higher than that of the MA group at 1 month postoperatively,and the difference was statistically significant(108.93±°13.63 in the KA group versus 101.45±°11.70 in the MA group,P=0.01).The range of motion of knee of the KA group was higher than that of the MA group at 3month postoperatively,and the difference was statistically significant(114.11°±12.40 in the KA group vs 107.10°±11.16 in the MA group,P=0.02).There was no significant difference in range of motion of knee between the two groups at 6 months after operation(P>0.05).At 1 month,3 months,and 6 months after the operation,there was no significant difference in the VAS score between the two groups(P>0.05).There was no statistically significant difference in HSS scores between the two groups at 1 months after operation(P>0.05),and the HSS score in the KA group was higher than that in the MA group at 3 months after operation,with a significant difference(82.93±7.87 vs80.29±5.61 in the MA group,P=0.03).There was no significant difference in the HSS score between the two groups at 6 months postoperatively(P>0.05).At 1 month,3months,and 6 months after operation,there was no significant difference in WOMAC score between the two groups(P>0.05).There was a statistically significant difference between the two groups in terms of range of motion of knee at 1 and 3 months and HSS score at 3 months after operation(P<0.05),the results indicated that KA group had superior curative effect compared with MA group in early postoperative period.As of the last follow-up,all patients had no complications such as deep vein thrombosis of the lower limbs and wound infection.Postoperative imaging results of all patients showed that the knee prosthesis was in good position,no periprosthetic X-ray bright line,peri-prosthesis fracture,osteolysis,prosthesis loosening,prosthesis sinking and other abnormalities.Conclusions:1.Both the kinematic alignment technique group group and the mechanical technique alignment group achieved good clinical outcomes in the early postoperative period.2.The operation time of the kinematic alignment technique group was longer than that of the mechanical alignment technique group.3.In the early postoperative period,the range of motion of knee and HSS score of knee in the kinematic alignment technique group were better than those in the mechanical alignment technique group,but there was no significant difference in WOMAC score and VAS score.4.In the early postoperative period,two groups did not have any adverse events such as prosthesis loosening,prosthesis infection and so on.Survival rates still requires long-term follow-up. |
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