Comparison Effects Of High Flexion Rotating Platform And Fixed Platform Prosthesis After Total Knee Arthroplasty

Objective:To investigate the clinical effect of high flexion rotating platform and high performance fixed platform prosthesis in total knee arthroplasty.Methods:Retrospective study analysis from January 2014 to December 2014,83patients(86 knees)underwent total knee arthroplasty in the department of joint surgery,affiliated hospital of chengde medical college.According to the different types of prosthesis divided the patients into high flexion rotation platform(RPF)group(46 cases,47 knees)and high performance fixed platform(HFB)group(37 cases,39 knees).The basic data of the patients were collected,including sex,age,ipsilateral,body mass index and perioperative bleeding.All patients were evaluated for osteoarthritis imaging grade using the Kellgren-Lawrence grading criteria based on imaging data.All patients were conducted by a senior physician who had undergone long-term arthroplasty surgery.Both groups patients' prosthetics and bone cement provided by Depuy.All patients were followed by a unified rehabilitation program.All patients were followed up for 2 years,the follow-up included the following: 1.Hospital for special surgery knee score(HSS),according to the last follow-up score to calculate the excellent and good rate(excellent,greater or equal to 85 points;good,70 to 84 points;moderate,60 to 69 points;poor,less than 59 points.).2.Knee mobility(ROM).3.Preoperative,postoperative and postoperative follow-up of the knee joint positive and lateral radiographs.4.Is there a complication after total knee arthroplasty.The knee pain and function were assessed by HSS score.Through the imaging date to observe the position of prosthesis,prosthesis loosening,prosthesis subsidence and ostrolysis.Results:All patients were followed up.There were 46 patients(47 knees)in RPFgruop,6 males and 40 females,aged 47-82(64.2±8.6)years,left 19 cases,right28 cases,body mass index 25.8±3.5kg/m~2,arthritis imaging grade ? grade 31 cases,? grade 16 cases,perioperative bleeding volume 1016.7±240.1ml.There were 37 patients(39 knees)in HFB group,11 males and 26 females,aged 52-81(64.9±8.1)years,left 20 cases,right 19 cases,body mass index26.1±3.9kg/m~2,arthritis imaging grade ? grade 26 cases,? grade 13 cases,perioperative bleeding volume 1012.3±297.9ml.There were no significant differences in age,ipsilateral,sex ratio,body mass index,osteoarthritis grade and perioperative bleeding between RPF group and HFB group,the difference was not statistically significant(P>0.05).All incisions healed by first intention,no skin necrosis and incision infection occurred.At the last follow-up,all patients had no prosthesis loosening,prosthesis sinking and deep venous thrombosis of lower extremity.No patellar fracture,dislocation of patella and patellar ligament injury and other complications occurred in all patients.However,there were 6 cases in RPF group,4 cases in HFB group with joint friction or joint snapping,the difference between the two groups was no statistically significant(P>0.05).HSS score of preoperative RPF group was 33.8±4.1 points,HFB group was 34.2±3.7 points,the last follow-up RPF was 90.3±3.5 points,HFB group was 89.4±4.4 points.There was a significant difference between the two groups of HSS score at the last follow-up and preoperative comparison(P<0.001);the last follow-up HSS score of the two groups was no statistically significant(P>0.05).ROM of preoperative RPF group was 86.0±9.4°,HFB group was84.4±9.3°,the last follow-up RPF group was 123.8±18.4°,HFB group was110.8±9.6°.There was a significant difference between the two groups in the last follow-up and preoperative(P<0.001),the difference between the last follow-up of two groups was statistically significant(P<0.001).Conclusions:1.The clinical efficacy of RPF prosthesis is similar to that of HFB prosthesis,the patient satisfaction is higher,but the RPF prosthesis can obtainhigher joint activity,and it is more suitable for patients with higher knee mobility requirements.2.RPF prosthesis pad rotation can provide patients with better knee adjustment ability,up and down stairs and other action effect is better.3.Due to the small sample size and short follow-up time,the long-term efficacy needs further follow-up.