Effect Of Preoperative Hypoproteinemia On Prognosis Of Patients With Rheumatoid Arthritis Undergoing Total Knee Arthroplasty

Objective: to investigate the prognostic value of total knee arthroplasty(TKA)in patients with rheumatoid arthritis(RA)complicated with hypoproteinemia before operation.Methods: 141 patients(13 males,128 females,214 knees)with rheumatoid arthritis from January 2010 to December 2015 were analyzed retrospectively.In the first affiliated hospital of Xinjiang Medical University,(TKA)patients underwent total knee arthroplasty for the first time were divided into low protein group and normal group according to the results of serum albumin level.The patients were followed up for 1-6years after operation.Comparison of knee society score(KSS)between low protein group and normal group before and after operation,visual analogue score(VAS),perioperative blood transfusion,hospital stay and hospitalization costs.Results: 141patients(214 knees)were aged 58 years(range: 25-79 years).The course of disease ranged from 15 days to 40 years(13 males and 128 females),75 patients with hypoalbuminemia(serum albumin < 35 g/L),75 patients with hypoalbuminemia(serum albumin < 35 g/L),75 patients with hypoalbuminemia < 35 g/L).In the normal group(serum albumin > g/L),the KSS clinical score was(30.29±15.66)in the low-protein group and in the low-protein group,the clinical score was(25.25±13.82),and range of motion(ROM)was(71.80 ±24.25 °),respectively.All patients were treated with primary replacement prosthesis(P < 0.05),and the functional score was(25.25 ±13.82),and the knee joint mobility was(71.80 ±24.25 °)before operation.Before discharge,the KSS clinical score was(60.95 ±6.57),the functional score was(61.33 ±6.94),and the preoperative ROM was(95.33 ±7.09)°.The VAS was(2.95 ±0.61)before discharge and(2.68 ±0.47)before discharge.The VAS score of the last follow-up was(2.95 ±0.61)and(2.68 ±0.47)respectively.(124.53 ±72.75)ml,blood transfusion volume was(616.0±541.03)ml;in hypoproteinemia group,and(0.17 ±0.42)min in hypoproteinemia group,(124.53 ±72.75)min.In the normal group,the preoperative KSS knee score was(28.20±12.87),the functional score was(22.98 ±12.41),the preoperative ROM was(72.73±20.40 °),and the KSS clinical score was(63.95 ±4.07)before discharge.The average score of functional improvement was(63.79 ±4.48),and ROM was raised on the fifth day after operation.The high average score was(98.03 ±5.74),the preoperative VAS score was(3.0 ±0.73),the VAS score was(3.0 ±0.46)before discharge,and the VAS score was(0.24 ±0.5)in the last follow-up.The perioperative dominant blood loss in the normal group was(106.36 ±44.43)ml,and the blood transfusion was(403.03 ±410.24)ml.There was no significant difference in sex,Preoperative hemoglobin,preoperative VAS score and perioperative dominant blood loss between the hypoproteinemia group and the normal group(P>0.05).Postoperative KSS score,hospitalization There were significant differences in blood transfusion volume,hospitalization time and cost between the two groups(P < 0.05).There was no significant difference in serum albumin between the two groups(P>0.05).Conclusion: hypoproteinemia before operation may affect the functional score,perioperative blood transfusion,hospital stay and hospitalization cost in patients with rheumatoid arthritis after arthroplasty,but the sample size of this study is relatively small.Long-term large samples are also needed for research.