The Effectiveness Of Total Knee Replacement(TKR) For Treatment Of Advanced Osteoarthritis Of The Knee Joint At Qinghai University Affiliated Hospital(QUAH) Considering The Clinical And Patients' Satisfaction

Objective: The purpose of this survey is, to evaluate the effectiveness of the surgical treatment with Total Knee Replacement(TKR), using “posterior stabilized prosthesis”, for advanced osteoarthritis of the knee joint in Qinghai University Affiliated Hospital(QUAH) in Xining, after undergoing all conservative therapeutic options, by evaluating clinic status and radiographics before and after the surgeries. Methods: During the time from September 2014 to February 2015, 50 patients(12 male, 38 female) with advanced osteoarthritis of the knee joint(76 knee joints in total), of which 26 cases were bilateral and 24 cases were unilateral, were included in the study. The average age was 61.5 years. Including criteria, as well as all pre- and postoperative evaluation parameters were chosen according to the “Society of Rheumatism Bone Disease” and “HSS” scoring system, which is composed of seven parts. All patients were operated on in accordance to the same operation procedure, implementing the TKR type “posterior stabilized prosthesis”. No patella replacement was performed in all patients. The patients were clinical examined and x-rays of the affected knee joint in 2 standardized views were done before and 1, 6, 8 and 12 months after the operation. The evaluation results were used to create a standard protocol for diagnosis and treatment for advanced osteoarthritis of the knee joint in QUAH.Results: The evaluation results of the HSS score show that there were 46 cases with excellent results(85-96 points), 28 cases with good results(72-84 scores), 2 cases with moderate results and no bad outcome. The average HSS score before operation of the knee joint was 45.7±6.8, and the average HSS score after operation was 86.3±7.7. The evaluation results show significant improvement in all evaluation criteria, an average improvement of 40.6 score points. Considering the most important criteria for the patient's life quality, pain and function(range of motion) of the knee joint, the evaluation revealed 37% improvement rate for pain and 12.8% improvement rate for function at the end of follow-up time(after 12 months). The follow-up results have statistical significance with p < 0.05. During the whole study time no complications, like for example incision infection or lower limb vein thrombosis, occurred.Conclusion: The evaluation results of the present study show a significant improvement in all evaluation criteria, pre-operative compared to postoperative, especially concerning pain and function as the most important for the patients' life quality. Total Knee replacement(TKR), like performed in the QUAH in Xining, is shown to be a very effective treatment for advanced osteoarthritis of the knee joint.