The Effects Of Different Cartilage Grades On The Prognosis Of Total Knee Arthroplasty

Background:Osteoarthritis is a kind of joint degenerative disease caused by age,obesity,strain,trauma and other factors.It is a chronic disease characterized by degeneration of articular cartilage,reactive deformation of joint edges and subchondral bone.The clinical manifestations include slow-developing joint pain,tenderness,stiffness,joint swelling,limited mobility,and joint deformities.The incidence of osteoarthritis has shown an increasing trend in recent years.For patients with progressive joint deformity and persistent pain,surgical treatment is feasible in the case of ineffective treatment.At present,the force line deviation caused by single compartment lesions can be corrected by unicompartmental knee arthroplasty or high tibial osteotomy.But for patients with end-stage two-compartment and three-compartment lesions,total knee arthroplasty is still an important surgical procedure to eliminate joint pain,improve quality of life,and improve joint function.In patients who require total knee arthroplasty,there is a lot of controversy about whether or not to receive a tibial replacement during the same period.Some studies have shown that in total knee arthroplasty,replacement of the tibia has no effect on the prognosis of the surgery,and some studies suggest that the degree of degenerative treatment of the tibia and articular surface of the knee should determine whether or not the humeral replacement is needed.Therefore,whether the degree of tibia wear will affect the prognosis of total knee arthroplasty for the preservation of the tibia will affect our choice of surgical methods in the treatment of severe knee osteoarthritis,but currently the medical community The relationship between them is still inconclusive.Therefore,it is important to understand the effect of different degree of tibiofibular articular surface abrasion on total knee arthroplasty after treatment and rehabilitation of knee osteoarthritis.Objective:To investigate the clinical effect of total knee arthroplasty combined with patelloplasty and sacral denervation in the treatment of knee pain in knee osteoarthritis and its correlation with cartilage degeneration.Method:Retrospective analysis of clinical data of patients who underwent total knee arthroplasty in the joint surgery of Qilu Hospital of Shandong University(according to the standard of this article)2017.6—2018.9.A total of 52 patients with knee osteoarthritis were included,including 35 patients with right knee and 17 patients with left knee.The patients were aged 50-85 years with an average of 65.85 years old.Divided them into two groups according to Outerbridge classification.Patients with tibia grade ?-? were in the low-wear group(32 patients),and patients in the tibia grade IV were in the high-wear group(20 patients).The data collected were analyzed by SPSS19.0.There was no significant difference in gender and age between the two groups,which satisfied the comparability.The preoperative lysholm score,HSS score,VAS score and Feller score score were measured and recorded in the two(?)oups,and the height and weight information of the patient were collected and the BMI value was calculated.The lysholm score,HSS score,VAS score and Feller score were measured and compared at 1 month,3 months and 6 months after operation in both groups.Result:Regarding the preoperative functional score,the lysholm score,HSS score and Feller score were higher in the mild wear group than in the severe wear group,and the difference was statistically significant(P<0.05).The mean value of VAS scores in the mild wear group was lower than that in the severe wear group,but there was no significant difference between the two groups(P>0.05).Regarding the postoperative functional score,in the same group of patients with knee wear,the lysholm score,HSS score,and Feller score were 1 month after surgery compared with 3 months after surgery,1 month after surgery,and 6 months after surgery.There were significant differences between the months and the 3 months after surgery,and the two were statistically significant(P<0.05).There was no significant difference in lysholm score,HSS score and Feller score between the two groups at 1 month,3 months and 6 months after operation(P>0.05).For the VAS score,the patients in the same group had a significant difference from the preoperative and postoperative 3 months to the 1 month after surgery,and the two were statistically significant(P<0.05).There was no significant difference in VAS score between the 6 months postoperatively and the 3 months postoperatively(P>0.05).There was no significant difference in VAS scores between the two groups at 1 month,3 months,and 6 months after surgery(P>0.05).In addition,the BMI of the patients with mild tibia wear was(24.7003 ± 3.19429),and the BMI of patients with severe tibia wear was(30.1871 ± 3.33475),and there was a statistically significant difference(P<0.05).Conclusion:In knee osteoarthritis,the degree of cartilage degeneration is related to BMI,that is,the greater the BMI,the more severe the patellofemoral joint degeneration.The lysholm score,HSS score and Feller score of the preoperative mild wear group were generally higher than those of the severe wear group,and there was a statistically significant difference between the two,indicating that the more severe the cartilage degeneration,the worse the knee joint function,the knee pain.The more obvious.For the visual pain score,because the assessment is not only affected by the patellofemoral joint surface,but also by the tibial plateau joint surface,although the mean value of the VAS score in the mild wear group is higher than that in the severe wear group,there is no statistical difference between the two.Learn the difference.All postoperative scores were improved compared with preoperative,and the statistical differences were significant,indicating that total knee arthroplasty is effective in the treatment of severe knee osteoarthritis;There was no significant difference in lysholm score,HSS score and Feller score between the two groups,indicating that the surgical methods have good therapeutic effects for osteoarthritis with different degrees of cartilage degeneration.Postoperative follow-up was significantly improved compared with the previous follow-up,suggesting that active and effective rehabilitation within 6 months after surgery can significantly improve the functional recovery of patients.