| Objective:Total Knee Arthroplasty (TKA) has been used in clinical joint surgery since the sixties of the 20th century, which is a very mature surgery currently. TKA adopts a fixed-platform and rotating-platform prosthesis to replace dysfunction prosthesis knee. Because the fixed-platforms prosthesis have some defects, the rotating-platform prosthesis began to be used more and more in clinical surgery. The comparative study between the fixed-platforms prosthesis and the rotating-platform prosthesis in the joint function recovery in 3 years after total knee arthroplasty to evaluate the clinical efficacy and prognostic factors analysis between them.Methods:This article adopts the ambispective cohort study. A total of 155 patients,170 knees, with osteoarthritis who have undergone the primary total knee arthroplasty surgery in the Second Xiangya Hospital of Central South University from 2005年1月to2010年10月。All cases who have informed consent have the same preoperative condition and vital signs for total knee arthroplasty surgery.155 patients are randomly divided into 2 groups, a fixed-platform group and rotating-platform group,whose physicians are the same. All cases used the same functional recovery after TKA. Within 1 year after discharging every 3 months, after 1 year discharging every 6 months, all cases were followed up by backing to hospital. Using knee joint function score to evaluate the function of knee joint before and after surgery, every following up. Adopting t test and Chi-square text to analyze the clinical efficacy comparison between fixed-platform and rotating-platform prosthesis. Prognosis of patients with total knee arthroplasty is affected by many factors, including general situation, illness, past medical history, family history and surgical conditions, among various factors may be exist some complex relationship. In order to investigate the prognosis factors of the patients after total knee arthroplasty, the study uses proportional hazards regression model to analyze prognostic factors.Results:There are no significant differences in general situation, past medical history and family history before surgery between fixed-platform and rotating-platform prosthesis patients in total knee arthroplasty. The knee joint function scores between fixed-platform and rotating-platform are 48.74±5.35 and 49.63±5.07, respectively, there are no significant differences(p=0.300). Different dimensions in the knee joint function scores in 2 prosthesis also have no significant differences. The degree of knee between fixed-platform and rotating-platform before surgery are 66.87°±11.28°and 65.53°±12.69°,respectively, there are no significant differences (p=0.491).The periods in hospital between fixed-platform and rotating-platform are 17.89±4.55 days和16.61±4.20 days, respectively, there are no significant differences. After surgery the knee joint function scores between fixed-platform and rotating-platform are 76.16±6.77 and 77.70±7.03, respectively, there are no significant differences(p=0.172). Different dimensions in the knee joint function scores in 2 prosthesis also have no significant differences after surgery. The degree of knee between fixed-platform and rotating-platform after surgery are 98.13°±5.78°and 98.23°±5.76°, respectively, there are no significant differences (p=0.913). The critical periods of rehabilitation of patients are six months after discharge, The knee score from good to excellent rank.In 3 years after discharge, there are no significant differences in the clinical efficacy between 2 platform prosthesis, which can also obtain satisfying treatment. Useing proportional hazards regression model to analyze prognostic factors, Overweight and obesity(BMI>24), diabetes, complications are risk factors influencing the prognosis of TKA. In 3 years after discharge, the possibility of overweight and obesity(BMI>24), diabetes, complications patients can not be achieved excellent are 1.772(95%CI:1.047-2.833),2.629(95%CI:1.547 4.467),1.838(95%CI:1.038～3.255, respectively, comparing with other patient.Conclusions:The knee joint function score of TKA patients after discharge can achieve excellent in the 3 years,and the effects are stable. Overweight and obesity(BMI>24), diabetes, complications are risk factors influencing the prognosis of TKA. These patients should been taken the appropriate therapeutic measures to alleviate the suffering of patients and improve efficacy of patients.
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