Effect Of Overstuffing On Function After Total Knee Arthroplasty With Preservation Of Patella

Objective:To investigate the effect of anterior condyle and posterior condyle overstuffing on the function after total knee arthroplasty.Methods:A total of 107 patients with patellar sparing total knee arthroplasty for osteoarthritis from March 2019 to May 2020 were selected,including 27 males and 80 females.At age46 to 85,the average(67.1 + 7.4)years of age,and by X-ray digital imaging technology in knee joint measurement on the standard side slice: patellar thickness before and after operation,preoperative before femoral condyle thickness,fake devices for postoperative condyle thickness,thickness of femoral condyle after preoperative and postoperative prosthesis after the thickness of the condyle,preoperative patellofemoral joint distance and patellofemoral joint distance after the operation.The thickness of the anterior femoral condyle of the prosthesis after surgery minus the thickness of the anterior femoral condyle before surgery was greater than 0,which was defined as the filling of the anterior femoral condyle.Less than or equal to 0 is defined as non-filling of the anterior femoral condyle.The thickness of the femoral posterior condyle of the prosthesis after surgery minus the thickness of the femoral posterior condyle before surgery was greater than 0,which was defined as the filling of the femoral posterior condyle.Less than or equal to 0 is defined as non-filling of the posterior femoral condyle.All the samples were divided into four groups: anterior condyle filling group,posterior condyle filling group,anterior and posterior condyle filling group,and no filling group.The differences in WOMAC score,KSS score,HSS score,VAS score and pain recovery time among the groups were compared one year after surgery.Results:There was no significant change in the thickness of the anterior condyle of femur before and after operation,and the difference was not statistically significant(P>0.05);Patellar thickness decreased after operation compared with that before operation,and the difference was statistically significant(P<0.05);After operation,the patellofemoral joint distance was decreased compared with that before operation,and the difference was statistically significant(P<0.05);The thickness of the posterior condyle of the femur was increased after operation,and the difference was statistically significant(P<0.05),the score of postoperative pain indicators in the pre and post condyle implantation group was higher than that in the post condyle implantation group,and the difference was statistically significant(P<0.05).In the postoperative stiffness indexes of WOMAC,the anterior condyle filling group scored higher than the non-filling group,and the difference was statistically significant(P<0.05).Postoperative mobility of HSS was higher in the anterior condyle filling group than in the non-filling group,and the difference was statistically significant(P<0.05).The postoperative anterior knee pain VAS score of the anterior condyle group was significantly higher than that of the anterior condyle group,the difference was statistically significant(P<0.05);One year after surgery,the passive flexion activity of the anterior condyle filling group was higher than that of the non-filling group,and the difference was statistically significant(P<0.05).One year after the operation,the active flexion activity of the anterior condyle filling group was greater than that of the non-filling group,and the difference was statistically significant(P<0.05).The Angle of buckling degree of the precondylar filling group was larger than that of the non-filling group under loading,and the difference was statistically significant(P<0.05).The Angle of flexion under loading was larger in the anterior and posterior condyle filling group than in the non-filling group,and the difference was statistically significant(P<0.05).Conclusion:Overfilling phenomenon widely exists in total knee arthroplasty,and the anatomical structure of the distal femur and the impersonal design of the prosthesis are the reasons for this phenomenon.Mixed filling of the anterior and posterior condyle will show more intense pain,and overfilling can also increase the range of flexion activity after surgery.