The Study Of Effect Of Bone Marrow Edema On The Efficacy Of Unicompartmental Knee Arthroplasty

ObjectiveThe unicompartmental knee arthroplasty(UKA)as one of the ways to treat osteoarthritis of medial compartment of knee joint has been carried out in the country gradually.In this study,we explore the differences early efficacy of UKA for the treatment of patients with knee joint medial compartment osteoarthritis preoperative bone marrow edema or not.MethodsWe study a retrospective analysis of Guangdong Provincial Hospital of Traditional Chinese Medicine bone three subjects from January 2015 to December2016 underwent UKA in the treatment of knee joint medial compartment osteoarthritis in 71 patients(71 knees).There were 25 males and 46 females,32 left knees and 39 right knees,ranging in age from 53 to 86 years with a mean of 66.49 years old.The BMI ranged from 21.10 to 33.20kg/m2 with an average of 25.18 kg/m2.The average follow-up time was 21.55 months.We assess the preoperative knee magnetic resonance in the medial compartment of the degree of bone marrow edema(BME),divided into level 0,level 1 and level 2 in total3 groups and divided into F-BME,T-BME and A-BME altogether 4 groups by location.We collected the data of operation time,intraoperative blood loss,WOMAC score,HSS score,VAS score and satisfaction degree before and at the last follow-up,combined with clinical manifestations and posterior knee X-ray film to assess the presence or absence of postoperative complications of UKA.The data were processed and statistically analyzed using SPSS 18.0 software(P<0.05considered statistically significant).ResultsA total of 71 patients(71 knees)were studied,including 25 males and46 females,32 left knees and 39 right knees,ranging in age from 53 to 86years(average 66.49 years)with BMI ranging from 21.10 to 33.20 kg/m~2,an average of 25.18 kg/m~2.The average follow-up time was 21.55 months.In all cases,there were 25 cases of grade 0 bone marrow edema,22 in grade 1 and24 in grade 2.Bone marrow edema in femoral medial condyle(F-BME)in 13 cases,simple medial tibial plateau edema(T-BME)in 14 cases,bone marrow edema in medial femoral condyle and medial tibial plateau(A-BME)in 19 cases,medial tibial plateau and femoral medial condyle without bone marrow edema(N-BME)in 25 cases.During the follow-up period,3 patients showed postoperative pain and were relieved again after symptomatic treatment.No infection,prosthesis loosening or sinking,periprosthetic fracture,unexplained pain,polyethylene liner dislocation,deep venous thrombosis of the lower extremities and complications such as pulmonary embolism were observed in all cases.The preoperative and postoperative WOMAC score,HSS score and VAS score of each group were significantly different(P<0.05).There was no significant difference in WOMAC score,HSS score,VAS score and satisfaction between groups(P>0.05).ConclusionThe results show that the UKA of medial compartment of knee osteoarthritis surgery for a short time,less blood loss,good early effect after surgery,the extent and location of bone marrow edema on the UKA early effect has no effect,and far Period effect needs further observation.