| Objective1.By analyzing the data of volumetric CT scan,the motion trajectory curve was analyzed to study the changes of patella's motion trajectory,and the corresponding conclusions were drawn.2.The Opti-Knee joint three-dimensional motion measurement system based on advanced optical positioning and tracking technology is used to analyze the kinematic parameters of KOA patients after the fourth generation Oxford unicompartmental knee arthroplasty,and to investigate the effect of the fourth generation Oxford unicompartment on the operation of patients with KOA.3.To study the curative effect of rehabilitation after the fourth generation Oxford unicompartmental knee arthroplasty combined with traditional Chinese medicine external washing,and draw the corresponding conclusion.Methods1.This study consists of three parts: kinematics analysis,movement trajectory analysis and postoperative Chinese medicine washing intervention.(1)From January 1,2016 to December 31,2017,20 patients with knee osteoarthritis(KOA)who were hospitalized in Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine for the fourth generation of Oxford unicompartment were selected as the unicompartmental knee arthroplasty group.Twenty volunteers with normal knee joint function were recruited as healthy group.The healthy volunteers were scanned with volume CT at different flexion angles of 0-105 degrees.The patients in the unicompartmental knee arthroplasty group were scanned with volume CT before and 12 months after the operation to obtain dynamic knee joint data.When the knee joint was at 0,15,30,45,60,75,90 and 105 degrees,the patella inclination angle,patella internal and external rotation angle,relative longitudinal displacement of patella center,and medial and lateral displacement of patella were measured.Paired t-test was used to compare the differences in the observation indexes of the unicompartmental knee arthroplasty group at different flexion angles before and 12 months after surgery.The independent sample t-test was used to compare the differences of observation indexes between the healthy group and unicompartmental knee arthroplasty group at 12 months after the operation under different flexion angles.(2)From January 1,2016 to December 31,2017,20 patients with knee osteoarthritis who were hospitalized in Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese medicine for the fourth generation of Oxford unicompartment were selected as the unicompartmental knee arthroplasty group.Twenty healthy volunteers were recruited as the healthy group,and the gait parameters of healthy people with normal knee joint function were collected and analyzed.The gait parameters were collected before and 12 months after the operation in the unicompartmental knee arthroplasty group.The optical knee joint 3D motion measurement system based on advanced optical positioning and tracking technology is used for kinematic parameter acquisition.The main observation indexes are maximum extension angle,maximum buckling angle,maximum varus angle,maximum internal rotation angle,maximum external rotation angle,maximum forward displacement,maximum backward displacement,maximum up displacement,maximum downward displacement,maximum internal displacement and maximum external displacement.Compare the difference of the abovementioned observation indexes in the unicompartmental knee arthroplasty group before and 12 months after the operation.The independent samples t test was used to compare the differences in the observation indexes between the healthy group and the unicompartmental knee arthroplasty group at 12 months after surgery.(3)A retrospective analysis of the follow-up data of 60 patients who were hospitalized at the Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine and received fourthgeneration Oxford unicompartmental knee arthroplasty from January 2016 to December 2017.The patients were divided into treatment group and control group according to whether Shujinxi granules were used or not.In the treatment group,Shujinxi granules were dissolved in about 2L warm water(about 42 ?)for hot compress and hot washing for 15-20 minutes each time,twice a day.The control group did not use this medicine.The evaluation indexes included visual analogue pain scale(VAS),American Osteoarthritis Index(WOMAC),Lysholm knee joint score(Lysholm)and American Society of knee arthroplasty score(KSS)at the follow-up time of 3 months,6 months and 12 months after the operation.Results1.Compared with the medial and lateral displacement of the patella in the unicompartmental knee arthroplasty group before and 12 months after the operation,the difference in the measured values at the knee flexion angle was statistically significant except for 75°(P<0.05).Compared with the healthy group,the medial and lateral displacement of patella at flexion angle of 60° and 105° had statistical difference(P<0.05),while the other values had no statistical difference(P>0.05).In comparison of relative longitudinal displacement of patella center under all knee flexion angles,there were statistically significant differences in all knee flexion angles between the healthy group and unicompartmental knee arthroplasty group at 12 months after the operation,and that between the unicompartmental knee arthroplasty group before the operation and 12 months after the operation(P<0.05).There were statistically significant differences between the measured values of the internal and external inclination of the patella at all knee angles before and 12 months after the operation in the unicompartmental knee arthroplasty group(P<0.05),and there were no statistically significant differences between the measured values of the internal and external inclination of the lower patella at all knee angles in the healthy group and 12 months after the operation of the unicompartmental knee arthroplasty group(P>0.05).In addition,in the unicompartmental knee arthroplasty group,there were significant differences in the measurement of patellar internal and external rotation angle under the knee flexion angle before and 12 months after the operation,except for the knee flexion angle of 0°(P<0.05).There was significant difference between the healthy group and the unicompartmental knee arthroplasty group at 75° knee flexion angle at 12 months after the operation(P<0.05),while there was no significant difference in the other knee flexion angles(P>0.05).2.The results showed that there were statistically significant differences in the kinematic parameters of the unicompartmental knee arthroplasty group before and 12 months after the operation(P<0.05).Compared with the healthy group,there was no significant difference in the three parameters of maximum external displacement,maximum internal displacement and maximum right angle extension(P>0.05),while the other kinematic parameters were statistically significant(P<0.05).3.The VAS score and WOMAC score of the two groups were decreased at 3months,6 months and 12 months after the operation,and the differences were statistically significant(P<0.05).the Lysholm score and KSS score of the two groups were increased at 3 months,6 months and 12 months after the operation,and the differences were statistically significant(P<0.05).Conclusion1.Under strict inclusion criteria,suitable cases were selected and the fourth generation Oxford unicompartment was performed for KOA patients with satisfactory short-term patellofemoral joint motion recovery effect,which could restore the patellar motion track to the normal physiological condition.2.The fourth generation Oxford unicompartment can improve the kinematic parameters of the gait of patients with knee osteoarthritis,promote the recovery of knee joint function,and make the knee function of patients tend to normal physiological state.3.The fourth generation Oxford unicompartment can effectively improve the joint function of patients with KOA,and the effect can be further improved by the combination of postoperative Chinese medicine washing. |
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