Comparison Of Short-term Clinical Efficacy After TKA Using Cruciate-retaining Rotating Platform And Fixed-bearing Prostheses For The Treatment Of Knee Osteoarthritis And Community-based Rehabilitation After TKA

Objective To compare the short-term clinical efficacy between posterior cruciate retaining prosthesis and posterior stable fixed-bearing prosthesis in total knee arthroplasty(TKA) for the treatment of knee osteoarthritis and to observe the effect of community-based rehabilitation in the functional recovery after TKA.Methods 108 knees were selected from January 2011 to October 2011 which suffered serious knee osteoarthritis and received TKA. 56 knees used posterior cruciate retaining prosthesis(A) and 52 knees used posterior stable fixed-bearing prosthesis(B). The HSS knee score and the range of motion(ROM) of the knee were collected and evaluated. There are 18 cases in group A received community-based rehabilitation after discharge, which were compared with the rest cases in HSS pain score and patient satisfaction at the time of three months, half a year and one year after operation.Results Both of the general information containing age, BMI and gender distribution and preoperative clinical data containing HSS score and ROM have no statistical different. All patients that underwent the TKA were recovered satisfactorily, and obtained more than 2 years follow-up. There was significant improvement in the pain, function and activity of the knee. In group A, the preoperative HSS score was 41.00±4.34, which was 86.50±7.57 two years after operation(P=0.00). The knee rangeof motion before operation was 61.93±18.22, and it increased to 122.17±3.92 two years later(P=0.00). In group B, the preoperative HSS score was 43.85±3.26 and the knee range of motion was 62.75±10.06, which was 85.69±8.34(P=0.00) and 120.33±4.15(P=0.00) two years after operation. The HSS score, knee range of motion have no significant statistically different two years after operation. None of the patients appeared postoperative infection, loose and abnormal sound. The HSS pain score and patient satisfaction of the 18 cases were better than the rest cases in group A at the time of three months and half a year after operation, but at one year the two indicators have no significant statistically different.Conclusion Both of the posterior cruciate retaining prosthesis and posterior stable fixed-bearing prosthesis have good short-term clinical efficacy for the treatment of knee osteoarthritis in TKA. Although the rotating platform has better performance at polyethylene bearing and kinematics in theory, it does not reflect in the research. The community-based rehabilitation after TKA could relief early pain and improve patient satisfaction.