Clinical Observation Of Gemini MK ? Rotating Platform Prosthesis In The Treatment Of Rheumatoid Arthritis Of The Knee

Objective: To observe the Gemini MK ? rotating platform prosthesis for total knee arthroplasty(total knee arthroplasty,TKA)for the treatment of rheumatoid arthritis of the knee(rheumatoid arthritis of the knee,RA)effect.Methods:A retrospective analysis of june 2007 to june 2014,the First Affiliated Hospital of Soochow University Department of orthopedics by Gemini MK ?,rotating platform prosthesis(link,Germany)for the first time TKA surgical treatment of patients with rheumatoid arthritis in 24 cases(34 knees)of the clinical data according to the sodium entry and exclusion criteria.There were 4 males(6 knees)and 20 females(28 knees),aged from 52 to 77 years,with an average age of 60.0± 7.8 years.There were 14 cases in unilateral,bilateral in the same period in 4 cases,and bilateral staging was performed in 6 cases.Preoperative course was 8~22 years(mean: 14.0± 5.6).Objective to investigate the clinical advantages of the prosthesis in the treatment of RA patients with TKA,and to analyze and summarize the main points of functional rehabilitation and surgical techniquesof RA patients undergoing TKA treatment.The American Knee Society score(American Knee Society knee score,KSS score)system,knee joint activity(range of motion,Rom),visual analogue scale(visual analogue score,vas),Feller patellar score,subjective satisfaction,as the clinical curative effect of surgery according to the final evaluation.Whether or not the prosthesis was loosened was observed by observing whether or not there was a clear line around the prosthesis.Results: All patients were followed up for an average of 62.1 months(range from 24 months to 96 months).There were 2 cases(2 knees)with superficial infection of incisional skin during the perioperative period.After strengthened changing dressings,the infection was controlled;1 case(1 knee),decreased sensation of the skin on the dorsum of the foot and on the outside of the leg.The reasons may be traction injury of the common peroneal nerve in the operation,and the symptoms disappeared by nutritional nerve treatment after 3 months follow-up.1 case(1 knee)were followed up after operation 3 months appear stiff joints,to strengthen follow-up frequency,guiding function exercise,improve the symptoms after 1 years.In other cases the first stage incision were healing,no wound infection,pulmonary embolism and other complications.6 months after operation,3 patients(3 knees)were not satisfied with the early complications,the subjective satisfaction was 91.2%.At last follow-up,1 patients(1 knees)were not satisfied with the result of poor functional recovery,the subjective satisfaction was 97.1%;the X-ray examination did not show loose or aseptic infection around the prosthesis.At the last follow-up,the knee KSS score,knee mobility(ROM),VAS pain score,and Feller patella score were significantly improved,and the difference was statistically significant compared with preoperation(p<0.05).Conclusion : Using Gemini MK ?,rotating platform prosthesis of total knee arthroplasty for the treatment of rheumatoid arthritis of the knee early stage satisfactory curative effect,long-term effect needs further clinical follow-up;appropriate prosthesis selection before surgery,surgical operation and postoperative rehabilitation of mature the system in operation is achieved excellent effect of guarantee.