| Objective:To study whether synovectomy during the total knee arthroplasty(TKA)on patients with osteoarthritis will affect the postoperative blood loss,long-term clinical results,and functional recovery of knee joint,in order to provide theoretical basis and reference for the clinical use of total knee Arthroplasty in the treatment of osteoarthritis.Methods:60 cases of osteoarthritis patients who underwent TKA treatment in our hospital were randomly divided into the observed group(30 cases)and the control group(30 cases).The patients in the observed group got synovectomy during the treatment,while the control group retained the synovial membrane during the treatment.The knee-pain-VAS scores and the degree of knee joint activity of all the two groups of patients were evaluated 24h,3 days,4 weeks and 12 months after the treatment.Knee-joint-HSS scores of all patients were evaluated 24h,3 days,4 weeks and 12 months after the treatment.The evaluation mainly included the pain,function,activity,muscle strength,joint flexion deformity and stability aspects.The scoring and evaluation were conducted by a team of experts who were not completely unaware of the experiment.The blood loss,the long-term clinical results and the recovery of knee function were compared between the two groups after treatment.Results:1.In the 30 patients in the observed group,the proportion of male was43.33%,the average age was 62.9±6.0,the prevalence rate of the left knee was56.67%,the disease duration was 8.08±2.34 years,the average body height was1.613±0.065 m,the average weight was 65.9±9.21 kg,the average BMI was22.56±7.45 kg/m~2,the average hemoglobin level was 1352±125 g/L,the average hematocrit was 38.4±6.8%,and the average prothrombin time before operation was9.6±0.94 s.In the 30 patients in the control group,the proportion of male was 40.00%,the average age was 63.6±5.7,the average prevalence rate of left knee was 63.33%,the disease duration was 8.48±2.14 years,the average body height was 1.622±0.072m,the average weight was 64.9±9.41 kg,the average BMI was 22.12±7.04 kg/m~2,the average hemoglobin level was 1363±136 g/L,the average red blood cell hematocrit was 38.6±5.9%,the average prothrombin time before operation was 9.5±0.85 s.There was no significant difference between the observed group and the control group in the general information(P>0.05).2.In the observed group,preoperative KSS clinical score was 36.9±5.86,preoperative KSS function score was 34.6±6.09,preoperative pain VAS score was8.2±0.71,preoperative HSS score was 39.18±6.33.In the control group,the preoperative KSS clinical score was 35.1±5.99,the preoperative KSS function score was 34.2±6.02,the preoperative pain VAS score was 7.9±0.63,and the preoperative HSS score was 40.23±5.98.There was no significant difference between the two groups in the preoperative scores(P>0.05).3.The observed group occult blood loss was 723.2±214.5 ml,significantly higher than the control group which was 532.4±195.2 ml(P<0.05).4.The average operation time was in the observed group was 110.5±24.3 min,which was significantly longer than the control group numbered as 90.6±20.3 ml(P<0.05).The dominant bleeding volume,recessive bleeding volume and total blood loss in observed group were 751.1±254.1 ml,723.2±214.5 ml,1556.8±345.3 ml,which were significantly higher than the control group numbered as 542.8±225.7 ml,532.4±195.2 ml,1086.9±243.3 ml(P<0.05).The length of stay in the observed group and the control group was 11.62±1.23 days and 10.98±1.25 days,respectively,and there was no significant difference between the two groups(P>0.05).5.The VAS scores of preoperative and 3 days,4 weeks and 12 months postoperative in observed group were 7.23±1.23,5.64±0.23,3.62±0.36,1.56±0.56,which had no significant difference with the control group numbered as 7.15±1.43,5.54±0.33,3.42±0.46,1.66±0.43(P>0.05).6.The HSS scores of preoperative and 3 days,4 weeks and 12 months postoperative in observed group were 39.18±6.33,47.23±6.14,65.16±5.92,85.69±9.12,which had no significant difference with the control group numbered as40.23±5.98,46.88±5.90,67.30±4.68,87.13±8.35(P>0.05).7.The incision of patients in observed group and the control group all healed,and no symptomatic pulmonary embolism and deep vein thrombosis,and no prosthesis loosening happened.The positive rate of floating patella test in observed group at 12months was 17.28%.The positive rate of floating patella test in control group at 12months was 18.99%,there was no significant difference between the positive rate of floating patella test in two groups(χ~2=0.078,P>0.05).Conclusion:During the treatment of knee osteoarthritis by TKA,whether do synovectomy or not will not influence the postoperative pain,the recovery of knee function.But synovectomy will increase the operation time and surgery blood loss.It is recommended that during the TKA treatment,do not take synovectomy. |
PDF Full Text Request