| Purpose:Evaluation of computer navigation-assisted total knee replacement surgery (TKA) with CPM treatment of advanced osteoarthritis of the clinical efficacy.Material and method:From December 2007 to January 2010 parallel computer navigation-assisted total knee replacement patients 39 cases of 46 knees in 39 cases were divided into two groups-control study. Among them, the use of CPM after functional exercise (experimental group) 18 cases of 20 knees, aged 6l～83 years old, with an average 7O. 4 years of age; 7 males and 8 knees, female 11 cases of 12 knees. The experimental group after the first two days up at the CPM a passive exercise, joint activities in the scope of the principle of a small pain, angle 0°～40°from the beginning of a round / min, continued to exercise 0.5～1 h, 2 times / d, later to rise each angle 5°～1O°, 2 times a day were treated 2-3 weeks. After not using CPM (control group) 21 cases of 26 knees, aged 65 to 82 years, mean 72.5 years; men and 9 cases of 11 knees, 12 females, 15 knees. Control group, 1～3 d for muscle relaxation and contraction exercises long enough to force Kamimagari moves under the foot, every 1 h 10, each time 3 S; suffering from knee to fully stretch out to do press-bed movement, every 2 h 1 groups, each 30 times, each time 10～15 S. After 4～7d began to adopt a thigh seat to mention, doing activities, knees, every 2 h 5～10 under; sideways, limbs in the last, doing weightless knee flexion, every 2 h 5 ~ 10 under; supine bed, the ipsilateral leg hanging edge of the bed his own initiative, knees, every 2 h hanging about 10 min. 8～14 d after the beginning bed straight leg raising exercise, raising 3O°can persist in 5～7 S, a day 3～4 groups, each 3O times; Rotary railings and do squatting exercises: Stick to 5-7 S, day 3～4 groups, each 30 times, gradually increase the amplitude; practice under the guidance of Ping Lu, devices to assist walking, 3 to 4 times a day, each time 10～20 min. After 3 weeks in patients with autonomous activities and other functional training methods and the experimental group basically the same. Two groups were the initial replacement, comparing patient's age, sex, KSS score and so the general situation, by the paired t test, line statistical analysis.Patients were compared before and after 2 weeks of the KSS score, knee activity and post-operative swelling subsided time, for statistical analysis.Results:Patients were followed up 6 to 12 months, an average of 9 months. Preoperative knee score and function score was no difference between the two groups was significant (P> 0.05); the experimental group and control group 2 weeks after knee scores were 65.4±4.92 and 61.9±3.83, function scores after 2 weeks respectively, 88.6±3.99 and 85.3±3.79, the difference between the two groups are statistically significant (P <0.05); the experimental group and control group knees, the time point of comparison, the pain-free knees 7O°and the time required to 2. 3±0.6d and 4.7±0.8d, between the two groups was significant difference (P <0.05); knees, the time required for≥95°respectively, 11.8±0.6d, and 18.3±0.5d,the experimental group and control group between the two groups was significant difference (P <0.05); knee swelling subsided time to reach the knee without swelling, mild swelling as the standard, the experimental group and control group were 6.3±0.5d and 10.2±0.8d, between the two groups are also significant difference (P <0.05).Conclusion:In advanced osteoarthritis in patients with flexion deformity, using computer navigation-assisted TKA osteotomy and soft tissue balancing to make more precise and postoperative follow-up patients suffering from knee and knee scores were significantly increased compared with the surgery to alleviate the chance of a significant knee pain, improve the chance of knee flexion and extension activities and functions. After suffering from knee function scores were significantly increased compared with surgery, surgery significantly improved the chance of knee walking mobility. After the surgical site with CPM and joints can promote blood circulation and promote intra-articular hematoma or swelling subsided, prompting the early wound healing, elimination of joint adhesions, prevent joint stiffness, improve joint mobility, correct deformities, improve patient quality of life. |
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