Clinical Study Of Bone Cement With Screw And Metal Block In The Treatment Of Rand C Type Tibial Defects In TKA

Objective:Toanalysis the short-term and mid-term clinical effect of Tibial Bone Defect of Rand C Type By Bone Cement with Screw and Metal Block in primary total knee arthroplasty(TKA).To provide a reference for selecting the appropriate treatment plan in TKA with bone defects by analysing the knee function score,knee joint(ROM),operation time,intraoperative blood loss and other indicators.Method:16 patients(16 knees)from the First People's Hospital of Chenzhou with Rand C Type Tibial Bone Defect were identified in the study.There were 6 males and 10 females with an average age of 67 years(range 55-88 years),including 10 cases of osteoarthritis,rheumatoid arthritis in 4 cases,traumatic arthritis in 2 cases,there are11 caseswith varus knee,and valgus knee in 4 cases.A total of 10 cases of bone cement(A group)(male 4 cases,female 6 cases),A total of 8 cases of metal block(group B)(male 2 cases,female 4 cases).X-ray,CT and MRI were used to evaluate the degree of bone defect before the operation.The knee function score(HSS),joint mobility(ROM),operative time,Bleeding volume and postoperative complications of the two groups were recorded.Regular follow-up was performed after operation and correlation index were Recorded.Finally,the clinical efficacy of Tibial Bone Defect of Rand C Type By Bone Cement with thoese two methods was analysed based onthe above indexes.Result:All the 16 cases were followed up,the mean follow-up time was 21 months(range 18 to 24 months).We get a preoperative average knee HSS score of the groups A and B:(27.50±3.06)and(24.17±3.92),the preoperative average Knee joint activity(ROM)of the groups A and B:(60.20±7.98)(63.33±9.31).The average knee HSS score after 6 and 9 months post-operatively and the average Knee joint activity(ROM)of the two groups : group A:HSS score after 6 and 9 months:(87.60±3.37)?(95.70±4.06);ROM after 6 and 9 months:(95.5±7.25)(100.08±5.81),group B:HSS score after 6 and 9 months:(90.00±3.58)?(92.83±4.71);ROM after 6 and 9 months:(92.83±6.80)?(95.83±5.85).The operative time and Bleeding volume of group A :(120.10.±17.45)min,(305.00±56.72)ml,group B:(129.83±16.86)min,(320.67±75.28)ml.Statistical results shows that the knee joint HSS score and ROM of the two groups are improved significantly compare to the preoperative scores.There was no significant differences in operation time,bleeding volume,complications and postoperative bed timeConclusion:For those patients who suffered from Rand C Type Tibial Bone Defect in primary total knee arthroplasty,If we have a Detailed preoperative preparation,careful intraoperative manipulation and strict grasp of surgical indications,we can get a good short-term and mid-term clinical effect by using bone cement with screw or metal block to repair bone defectbased on the results of our study.There was no statistical differences between the two methods.However,the choice of bone cement and screw can save more normal bone mass and save more medical expenses,it is worth to promotin clinical work.