| ObjectiveTo observe the early clinical effects,morphological and the recent gait of PS mobile-bearing prosthesis and fixed-bearing prosthesis after total knee arthroplasty.Methods30 patients with knee osteoarthritis in the Department of Sports Medicine of the First Affiliated Hospital of Kunming Medical University from March 2015 to March 2016.Which included 11 males and 19 females,the average age was(64.86±5.37)years.30 patients diagnosed knee osteoarthritis were randomly divided into mobile-bearing prosthesis group and fixed-bearing prosthesis group,and to give patients with total knee arthroplasty.All patients were followed up for clinical follow-up,Three-dimensional digital measurement and the three-dimensional gait analysis.ResultsThe HSS score,KSS score and WOMAC osteoarthritis index of post-operation with fixed-bearing group and mobile-bearing group improved significantly compare with the pre-operation.There was no significant difference in HSS score,KSS score and WOMAC osteoarthritis index postoperative between the two groups.There was significant difference in Hip-knee-ankle angle(HKA),posterior slope angle of the lateral tibial plateau,tibial angle,femoral angle and knee physical valgus angle and varus inclination of the proximal tibial between preoperation and postoperation(P<0.05);There was significant difference in Hip-knee-ankle angle(HKA),posterior slope angle of the lateral tibial plateau,tibial angle,femoral angle,knee physical valgus angle and varus inclination of the proximal tibial between pre-operation angles and normal angles of Chinese(P<0.05)measured on three-dimensional digital models;However,There was no significant difference between post-operation angles and normal angles of Chinese(P>0.05).There was no significant difference in the Hip-knee-ankle angle(HKA),posterior slope angle of the lateral tibial plateau,tibial angle,femoral angle,knee physical valgus angle and varus inclination of the proximal tibial between two groups of post-operation(P>0.05).There was no significant difference of the gait analysis for post-operation at 1 year between the two groups in the parameters such as the maximum valgus angle,the maximum internal rotation angle,the maximum external rotation angle,the maximum posterior displacement,the maximal anterior displacement,the maximum distal displacement,the maximum proximal displacement,the maximum internal displacement and the maximum external displacement.(p>0.05).But there was significant difference of the gait analysis for post-operation at 1 year between the two groups compared with normal date in the parameters such as the maximum internal rotation angle,the maximum external rotation angle,the maximum posterior displacement,the maximal anterior displacement,the maximum distal displacement,the maximum proximal displacement,the maximum internal displacement and the maximum external displacement(p<0.05).ConclusionIn this study,we found that both the PS mobile-bearing prosthesis and fixed-bearing prosthesis could get good results,better restore the morphology of the knee joint and good gait recovery.Part OneEarly clinical effects of PS fixed-bearing versus mobile-bearing prosthesis after total knee arthroplastyObjectiveTo observe the early clinical effects of PS mobile-bearing prosthesis and fixed-bearing prosthesis after total knee arthroplasty.Methods30 patients with knee osteoarthritis in the Department of Sports Medicine of the First Affiliated Hospital of Kunming Medical University from March 2015 to March 2016.Which included 11 males and 19 females,the average age was(64.86±5.37)years.30 patients diagnosed knee osteoarthritis were randomly divided into mobile-bearing prosthesis group and fixed-bearing prosthesis group,and to give patients with total knee arthroplasty.And the data of the Hospital for Special Surgery(HSS),Knee Society Score(KSS)and Western Ontario MacMaster(WOMAC)were collected at pre-operation and 1 month,3 months,6 months,and 1 year post-operation respectively.The early clinical outcomes of the two groups were analyzed by statistical analysis.ResultsThere was no significant difference in age,BMI and all knee score before operation between the two groups(P>0.05).All patients recovered well postoperatively,no complications such as necrosis of operative incision,infection,and deep vein thrombosis.The HSS score,KSS score and WOMAC osteoarthritis index of post-operation with fixed-bearing group and mobile-bearing group improved significantly compare with the pre-operation.There was no significant difference in HSS score,KSS score and WOMAC osteoarthritis index postoperative between the two groups.ConclusionIn this study,we found that both the PS mobile-bearing prosthesis and fixed-bearing prosthesis could get good results and significantly improve the knee joint function after the total knee arthroplasty.Part TwoComparison analysis of three-dimensional digital measurement between PS Fixed-bearing and mobile-bearing prosthesis after Total Knee ArthroplastyObjectiveTo construct the three-dimensional model of mobile-bearing prosthesis group and fixed-bearing prosthesis group based on two-dimensional CT image data of preoperation and postoperation,To observe whether there were morphological differences between the two groups.Methods1.30 patients with knee osteoarthritis in the Department of Sports Medicine of the First Affiliated Hospital of Kunming Medical University from March 2015 to March 2016.Which included 11 males and 19 females,the average age was(64.86±5.37)years.30 patients diagnosed knee osteoarthritis were randomly divided into mobile-bearing prosthesis group and fixed-bearing prosthesis group,and to give patients with total knee arthroplasty.each group(n = 15).2.The image data of all both lower limb were collected by CT scaning pre-operation and post-operation.The images were imported to Mimics 17.0 software in DICOM format,and three-dimensional digital model of limb were constructioned.The corresponding knee joint prostheses were selected and gotten 3D laser scan and reconstructed 3D models.Then 3D models of prostheses were fitted to knee joint models by point-to-point registering technology with Mimics 17.0 software.3.After the three-dimensional reconstruction,the two sets of models were measured by Mimics 17.0 software,included Hip-knee-ankle angle(HKA),posterior slope angle of the lateral tibial plateau,tibial angle,femoral angle,knee physical valgus angle and varus inclination of the proximal tibial.The results were compared between groups,and compared with the standard value of normal Chinese people.ResultsThere was significant difference in Hip-knee-ankle angle(HKA),posterior slope angle of the lateral tibial plateau,tibial angle,femoral angle and knee physical valgus angle and varus inclination of the proximal tibial between preoperation and postoperation(P<0.05);There was significant difference in Hip-knee-ankle angle(HKA),posterior slope angle of the lateral tibial plateau,tibial angle,femoral angle,knee physical valgus angle and varus inclination of the proximal tibial between pre-operation angles and normal angles of Chinese(P<0.05)measured on three-dimensional digital models;However,There was no significant difference between post-operation angles and normal angles of Chinese(P>0.05).There was no significant difference in the Hip-knee-ankle angle(HKA),posterior slope angle of the lateral tibial plateau,tibial angle,femoral angle,knee physical valgus angle and varus inclination of the proximal tibial between two groups of post-operation(P>0.05).ConclusionThree-dimensional digital measurement can measure the morphology of knee joint accurately,avoid by measurement error with manual measurement and no clear outline of bony marks when X-ray film.The results showed that both the mobile-bearing prosthesis group and fixed-bearing prosthesis group can better restore the morphology of the knee joint.Part ThreeThe three-dimensional gait analysis of PS fixed-bearing prosthesis versus mobile-bearing prosthesis after total knee arthroplastyObjectiveTo analysis the recent gait of the two groups with PS fixed-bearing prosthesis and mobile-bearing prosthesis after total knee arthroplasty,and to compare the differences in the walking gait of the fixed-bearing and the mobile-bearing after total knee arthroplasty by three-dimensional gait.Methods30 patients with knee osteoarthritis in the Department of Sports Medicine of the First Affiliated Hospital of Kunming Medical University from March 2015 to March 2016.Which included 11 males and 19 females,the average age was(64.86±5.37)years.30 patients diagnosed knee osteoarthritis were randomly divided into mobile-bearing prosthesis group and fixed-bearing prosthesis group,and to give patients with total knee arthroplasty.The three-dimensional gait analysis was performed for all patients for 1 year post-operation.At the same time,15 cases of healthy volunteers knee three-dimensional gait data were collected.The three-dimensional gait analysis of the two groups were analyzed by statistical analysis.And the three-dimensional gait of date about two groups were compared with the normal data.ResultsThere was no significant difference of the gait analysis for post-operation at 1 year between the two groups in the parameters such as the maximum valgus angle,the maximum internal rotation angle,the maximum external rotation angle,the maximum posterior displacement,the maximal anterior displacement,the maximum distal displacement,the maximum proximal displacement,the maximum internal displacement and the maximum external displacement.(p>0.05).But there was significant difference of the gait analysis for post-operation at 1 year between the two groups compared with normal date in the parameters such as the maximum internal rotation angle,the maximum external rotation angle,the maximum posterior displacement,the maximal anterior displacement,the maximum distal displacement,the maximum proximal displacement,the maximum internal displacement and the maximum external displacement(p<0.05).ConclusionThe three-dimensional gait analysis can be used to analyse the parameters after knee arthroplasty more accurately.There was no significant difference between the two groups of prostheses after total knee arthroplasty.But still have not recovery the normal gait. |
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