| Knee osteoarthritis is a chronic joint disease characterized by degeneration of knee cartilage and secondary osteogenesis.It is found that elderly women has a higher incidence than men.Total knee arthroplasty is a successful technique on the treatment of knee osteoarthritis.After TKA,due to physiological inflammation,the skin temperature of knee joint often increased,but the amplitude and duration of the increase varied greatly.Periprosthetic infection is a serious complication after TKA,and abnormal skin temperature increase is one kind of typical clinical manifestations after knee operation.Therefore,it is important to judge whether the elevated temperature of knee skin after TKA is caused by normal physiological inflammation or periprosthetic joint infection.Many scholars overseas and domestic have studied the phenomenon,but they have not reached a unanimous conclusion.Further research is needed about whether the hyperthermia of the knee after TKA is physiological or not and whether there is a correlation between the hyperthermia of the knee and the change of serologic indexes and the functional recovery of the knee.In this study,the basic information,local dermal temperature,serum index and functional score of KOA patients undergoing total knee arthroplasty were collected and analyzed.It is going to be explored about the correlation between local dermal temperature and serum indices and functional recovery of KOA patients after TKA in this study.In addition,this study may could help doctors to judge whether the knee skin temperature increase is caused by physiological inflammation after TKA and predict the functional recovery of knee joint by measuring skin temperature.Part one:The skin temperature changes after total knee arthroplasty.Objective:To study the variation of knee joint skin temperature and the difference of knee skin temperatures after total knee arthroplasty in patients after TKA.Methods:Patients who attended for a unilateral TKA due to primary osteoarthritis between September 2016 and March 2017 were included in the study.The skin temperature of both knees was monitored preoperatively and postoperatively using an infrared thermometer.Results:sixty-five patients were involved in the study.The operated knees,contralateral knees skin temperature and the differential skin temperature respectively were34.7±0.33℃,34.7±0.31℃,0±0.18℃;then they rose after operation,day 1 postoperative were 36.7±0.53℃,35.3±0.30℃,1.5±0.48℃;day 3 were 37.3±0.44℃,35.4±0.27℃,1.8±0.40℃;then they were at their highest on day 5(the peak respectively were37.5±0.38℃,35.7±0.29℃,1.9±0.39℃);then they declined,on day 7 they respectively were 37.3±0.38℃,35.5±0.27℃,1.9±0.44℃;on day 15 they respectively were37.0±0.33℃,35.1±0.27℃,1.8±0.36℃;on 1 month they respectively were 36.5±0.30℃,34.7±0.27℃,1.8±0.37℃;on 2 month they respectively were 36.1±0.30℃,34.7±0.26℃,1.5±0.36℃;on 3 months they respectively were 35.8±0.36℃,34.6±0.27℃,1.2±0.38℃;on half a year they respectively were 35.4±0.30℃,34.6±0.25℃,0.9±0.30℃;on 1year they respectively were 35.1±0.25℃,34.5±0.26℃,0.6±0.26℃.The differential skin temperature and the skin temperature of operated knee didn’t returned to preoperative values by Days 360,while the skin temperature of contralateral knees was approximately at preoperative values by Days 30.There was no statistical difference between the surgical and the contralateral knees on the preoperative level(p=0.069),and there were statistical differences between the two groups of skin temperature during every follow-up after the operation 1 year.Conclusions:The operated knees,contralateral knees skin temperature and the differential skin temperature firstly goes up and then goes down after TKA surgery.The contralateral knees skin temperature was approximately at preoperative values by one month,while the differential skin temperature and operated knee skin temperature didn’t returned to preoperative values by one year.There was no statistical difference between the surgical and the contralateral knees on the preoperative level(p=0.069),and there were statistical differences between the two groups of skin temperature during every follow-up after the operation 1 year.Part two:The serum indices changes after total knee arthroplasty.Objective:To study the changes of serum indices for 360 days following total knee arthroplasty(TKA).Methods:Patients who attended for a unilateral TKA due to primary osteoarthritis between September 2016 and March 2017 were included in the study.Serum indices were assessed in the study.Results:sixty-five patients were involved in the study.After TKA surgery,IL-6 and WBC were at their highest on Day 1(the peak respectively were 86.7±37.35 pg/ml、10.8±2.67*10~9/L),PCT,CRP and ESR were at their highest on Day 3(the peak respectively were0.38±0.150 ng/ml,77.7±39.95 mg/ml,66.1±12.89 mm/hr),HGB dropped to the lowest level on Day 5(the minimum is was 93±13.2g/L).WBC returned back to preoperative levels by Days 15,PCT,Il-6,CRP returned back to preoperative levels by Days 60,ESR returned back to preoperative level by Days 90,HGB returned back to preoperative level by Day 180.Conclusions:After TKA surgery,IL-6、WBC、PCT、CRP、ESR firstly goes up and then goes down,finally they returned back to preoperative levels by 3 months,HGB returned back to preoperative levels by 6 months.Part three:The correlation between knee skin temperature changes and serum indexes after total knee arthroplasty.Objective:To study the correlation between the changes of knee skin temperature and serum indexes after total knee arthroplasty in patients with knee osteoarthritis.Methods:Patients who attended for a unilateral TKA due to primary osteoarthritis between September 2016 and September 2017 were included in the study.The skin temperature of both knees was monitored preoperatively and postoperatively using an infrared thermometer.Serum indices were assessed.Results:The differential skin temperature was positively correlated with CRP in serum(P<0.05),and there was no significant correlation with PCT、IL-6,ESR,CRP and WBC.Conclusions:The differential skin temperature was positively correlated with CRP in serum and do not have significant correlation with other serum indices after TKA surgery.Part four:The correlation between knee skin temperature changes and knee functional after total knee arthroplasty.Objective:To monitor the changes of knee skin temperature and serum indices for 360 days following total knee arthroplasty(TKA)and find the relationship between the differential temperature and clinical outcome.Methods:Patients who attended for a unilateral TKA due to primary osteoarthritis between September 2016 and September 2017 were included in the study.The skin temperature of both knees was monitored preoperatively and postoperatively using an infrared thermometer.American knee society(KSS)knee scores were assessed.Results:There was a negative correlation between the differential skin temperature and the improvement of KSS score during the two follow-up visits(P<0.05),and there was no significant correlation with the patients’age,BMI,time of use of hemostasis,and time of operation.Conclusions:The differential skin temperature has a negative correlation with the improvement of KSS score during the two follow-up visits after TKA surgery. |
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