The Clinical Observation Of The Effect About One-stage Operation Of The Double Total Knee Arthroplasty On Treatment Of Advanced Knee Joint Osteoarthritis

Objective: The discussion of curative effect,safety and cost of treatment between one-stage and stage operation of the double knee total arthroplasty on treatment of advanced knee osteoarthritis.Methods: Various clinical parameters were analyzed in 62 patients with advanced double knee osteoarthritis who had accepted the double knee total arthroplasty between January 2009 and March 2015 in joint branch of Attached Ruikang Hospital of Guangxi University of traditional Chinese Medicine.Depending on the timing replacement surgery is divided into one-stage group(30 cases)and stage operation group(32 cases).Statistical comparison of two groups of patients with preoperative factors,operation safety,the difference of curative effect,the total hospitalization expenses(excluding prosthesis fee),length of hospital stay and postoperative complications.Patients with preoperative factors include gender,age,and preoperative basis of disease.Operation safety including operation time,total blood loss,total amount of blood transfusion.The quantitative criteria of the difference of curative effect is redicated by the preoperative and postoperative HSS,ROM,VAS score.The cases of complications and types are added up.Results: One-stage operation group has 30cases(22 cases of female,male8cases),stage operation group has 32 cases(22 cases of female,male10cases).one-stage and stage operation group had the similar sex,there was no statistically significant difference.The one-stage group of patients with an average of 73.4±5.6 years old,the stage operation group of patients with an average of 77.8±3.6 years old,the age difference between the two group had statistical significance,the age of one-stage group was smaller than stage operation group?s.The preoperative complications of the one-stage group had9 cases,that of stage operation group had 15 cases,but the difference between one-stage group and stage operation group had not statistical significance.The average total blood loss of one-stage group was 1409±99ml(including intraoperative blood loss and postoperative blood loss),the average blood transfusion of one-stage group was 5.23±0.94 U.The average total blood loss of stage operation group was 1400±109ml(including intraoperative blood loss and postoperative blood loss),the average blood transfusion of stage operation group was 5.4±1U.The difference of total blood loss and transfusion volume between one-stage group and stage operation group had not statistical significance.The average surgical operation time of one-stage group was 98.4±10.1min,the average total cost of hospitalization of one-stage group was 18776±2089 yuan,and the average length of hospital stay of one-stage group was 21.1±4.4 days,The average surgical operation time of stage group was 190.9±16.4min,the average total cost of hospitalization of stage group was 35300±5601 yuan,and the average length of hospital stay of stage group was 43.8±6.2 days.The average surgical operation time,the average total cost of hospitalization and the average length of hospital stay of stage operation group were significantly more than that of one-stage operation group,the difference have statistical significance(P < 0.05).The preoperative and postoperative HSS score of one-stage operation group was54.2±5.7 and 90.7±4.0.The preoperative and postoperative ROM of one-stage operation group was 85.3°±7.7°and 112.1°±6.3°.The preoperative and postoperative VAS score of one-stage operation group was 8.1±0.7 and2.2±0.8.The preoperative and postoperative HSS score of stage operation group was 53.6±5.6 and89.2±3.1.The preoperative and postoperative ROM of stage operation group was82.5°±7.2°and109.3°±5.6°.The preoperative and postoperative VAS score of stage operation group was 7.9±0.6 and 2.7±0.8.The difference of preoperative and postoperative HSS score,ROM and VAS score between the two groups operation all have not statistical significance,the postoperative HSS score,ROM and VAS score compared with the preoperative differences statistically significant(P < 0.05).The postoperative complications of one-stage group had 4 cases,the postoperative complications of stage group had 3 cases,the difference of postoperative complications between two groups has no statistical significance.The two groups of patients had no death.Conclusion(s):(1)Through the comparative analysis before and after the clinical effect of the treatment of this topic,one-stage operation and stage operation of the double total knee arthroplasty on treatment advanced knee joint osteoarthritis,the postoperative HSS score,ROM and VAS score had obvious improvement than that of the preoperative.The two operation had clinical effect.(2)Compared the two groups,The postoperative complications of one-stage group had not increased.The two groups of patients had no death.The two groups all had the same security,The surgical operation time,the total cost of hospitalization and the length of hospital stay of one-stage operation were less than that?s of stage operation.Such as patient condition allows,the patients who with advanced knee joint osteoarthritis may consider one-stage operation of the double total knee arthroplasty.