Clinical Study Of Two Ways In The Treatment Of Rand B Type Tibial Defects In TKA

Objective: To investigate the medium-term clinical efficacy of treating Rand B tibial plateau defect with two different methods including bone cement combined with screw and metal pad in primary total knee arthroplasty(TKA),and to make statistical analysis on the operation time,intraoperative blood loss,preoperative and intraoperative knee activity,indexes of knee function score(HSS),and postoperative complications for the two methods,so as to provide a reference for the better treatment of Rand B tibial plateau defect in TKA.Methods: Forty-eight patients diagnosed with Rand B type tibial plateau defect in the Joint Surgery Department of the Affiliated Hospital of Qinghai University from 2015.3 to 2019.6 and initially underwent TKA were selected.The patients were divided into two groups according to the operation method:group A was treated with bone cement combined with screw,group B was treated with metal pad.The operation time,intraoperative blood loss,preoperative and intraoperative knee activity,indexes of knee function score(HSS),and postoperative complications were statistically analyzed.Results: All 48 patients were followed up for 1 year.In group A and B,HSS score of knee joint was significantly improved.The intraoperative blood loss of Group A was apparently less than that of Group B,and there was no statistical significance in intraoperative bleeding volume.Conclusion: In the initial knee arthroplasty for Rand B tibial plateau defect,both bone cement combined screw and metal pad could achieve good structural reconstruction effect,and the function of affected limbs recovered well after operation.However,compared with metal pad implantation group,the bone cement combined screw group had less intraoperative blood loss,with shorter operation time,better bone mass preservation,and reduced the difficulty of re-revision surgery with a relatively low price,which is worthy of promotion in clinic.