Comparison And Prognostic Evaluation Of Arthroscopy Combined With High Tibial Osteotomy And Total Knee Arthroplasty In The Treatment Of Knee Osteoarthritis

Background:Knee osteoarthritis(KOA)is a common chronic degenerative disease in middle-aged and elderly people in China,often involving the medial compartment,and its prevalence and disability rate are high.Total knee arthroplasty is a traditional surgical procedure for treating KOA.It can provide good results for patients,but it cannot be accepted by the majority of patients because of the trauma,high cost,and end-stage surgery.In recent years,arthroscopy combined with high tibial osteotomy has been used as a knee-saving procedure,which is more easily accepted by patients.With the continuous improvement and improvement of the operation technology,the success rate and efficiency of the operation are getting higher and higher,and the incidence of postoperative complications is gradually reduced,which is considered as a feasible and efficient treatment.Objective:To compare the clinical efficacy of arthroscopy combined with high tibial osteotomy and total knee arthroplasty(TKA)in the treatment of knee osteoarthritis,and to evaluate the prognostic effects of three surgical methods on patients.Methods:131 patients(131 knees)who were treated in our hospital from February 2015 to February 2017 were selected as the study subjects.The clinical data were retrospectively analyzed.All patients were divided into the arthroscopy combined with high tibial osteotomy group(arthroscopy combined with high tibial osteotomy,68 patients with 68 knees)and total knee replacement group(total knee replacement,63 cases 63 knees),they were followed up for 1 year.The perioperative indicators(incision length,operation time,perioperative blood transfusion,post-operative time,hospitalization time,3-day hemoglobin decline),visual analogue scale(VAS)Western Ontario and McMaster Universities arthritis index(WOMAC),hospital for special surgery(HSS),American Knee Society score(KSS),the range of motion of knee joint before and at the last follow-up were compared between the three groups.the effect of follow-up treatment and complications within 1 year after operation were observed.Results:(1)Arthroscopic combined with high tibial osteotomy and total knee arthroplasty group,perioperative blood transfusion patients,operation time,postoperative time and hospital stay,there was no significant difference in hemoglobin after 3 days,no statistical difference Academic significance(P>0.05).(2)The VAS and WOMAC scores of the two groups after operation were significantly lower than those before operation,HSS scores,KSS scores and knee joint activity were significantly higher than those before operation,the differences were statistically significant(P < 0.05);There were no significant differences in VAS score,WOMAC score,HSS score,KSS score and knee joint activity between the two groups after operation.The difference was not statistically significant(P>0.05).(3)The postoperative complication rate of arthroscopic combined with high tibial osteotomy was 4.4%.The postoperative complication rate was 4.8% in the total knee arthroplasty group.There was no significant difference in the incidence of complications between the two groups.Conclusious:Arthroscopic combined with high tibial osteotomy and total knee arthroplasty is an effective surgical method for knee osteoarthritis,which can control the course of disease,alleviate clinical symptoms and improve the quality of life of patients.There are no significant differences between the two groups in the perioperative period and the short-term results.However,because the clinical follow-up time is short and the long-term efficacy cannot be evaluated,the conclusion has certain limitations.