Comparison Of Early Differences Between SMOC And Transvastus Total Knee Arthroplasty Based On Inflammation And Muscle Injury Markers

Objectives :To compare the early difference between SMOC and transvastus total knee arthroplasty by measuring the changes of serum markers reflecting muscle injury and inflammation.Methods:From July 2018 to November 2018,sixty-three patients were selected from587 patients and were divided into SMOC approach group(n=31)and transvastus approach group(n=32)according to the random number table method.SMOC approach and transvastus approach were adopted.The length of incision,operation time,blood loss and blood transfusion were recorded.Serum levels of creatine kinase(CK),c-reactive protein(CRP),tumor necrosis factor?(TNF-?),interleukin-1?(IL-1?),and interleukin-6(IL-6)were reviewed in 1.2.3 days after operation.Recorded and compared the straight leg elevation time,postoperative 3d VAS score,5cm peripatellar diameter.Postoperative 4w VAS score,KSS score,tibial femoral mechanical axis angle(MFTA)and congruence angle(CA),knee flexion.Postoperative 12 w VAS score,KSS score,knee flexion.Comparative analysis of these data.Results:There was no significant difference in preoperative data,operation time and intraoperative blood loss between the two groups(P>0.05).There was no significant difference in preoperative data,operation time and intraoperative blood loss between the two groups(P>0.05).The additional analgesia in group SMOC in 3 days was less than that in the transvastus group,and the difference was statistically significant(P <0.05).The postoperative 3dVAS score,4w VAS score and 4wKSS score of SMOC group were better than those of transvastus muscle group,and the difference was statistically significant(P<0.05).The levels of serum CK and CRP were higher than preoperative,and the SMOC group was lower than transvastus muscle group at 1d,2d,3d after operation,and the difference was statistically significant(P<0.05).The difference of serum TNF-?,IL-1/ ? and IL-6 after operation was not significant.There was no significant difference between the two groups at 1d,2d and 3d(P>0.05).There was no significant difference knee ROM between the two groups after 12w(P>0.05).No postoperative complications such as thromboembolic disease,dislocation of patella and infection occurred in the two groups.Conclusion:Muscle injury and inflammation caused by SOMC group are significantly less than those caused by transvastus group which can accelerate perioperative recovery.