| Objective:By comparing the early clinical function,pain,complications,and postoperative gait analysis of anterior-stabilized insert and posterior-stabilized insert after total knee arthroplasty to provide a basis for orthopedist to choose the corresponding prosthesis for patients with different conditions.Methods:50 Patients with osteoarthritis diagnosed in the Department of Orthopaedics,Guizhou Provincial People's Hospital from March 2018 to January2019 were selected and and the patients were divided into the AS group and the PS group using the random number table method(25 patients in the AS group and 25patients in the PS group),the two groups of patients selected the insert according to the group they belonged to,and both patients underwent unilateral total knee arthroplasty by the same surgeon.Follow-up was performed to record the preoperative and 1st,3rd,and 12th months knee society score,visual analogue scales,range of motion,and related complications to evaluate the early clinical outcomes of the two prosthetic insert.Use 3D gait analysis system(Opti?Knee?,YD-OK-964-DSP18)to obtain kinematic parameters of patients at 1st,3rd,and 12th months after surgery to evaluate dynamic motion Learning situation.Results:A total of 44 patients completed all follow-ups,including 23 in the AS group(5 males and 18females)and 21 in the PS group(6 males and 15 females).The age of the AS group and the PS group was(70.91±6.96)years and(68.38±8.21)years.The body mass index of the two groups was(25.33±3.20)kg/m~2and(24.83±2.91)kg/m~2.The general data of the two groups of patients are comparable(P>0.05).The preoperative KSS,preoperative VAS and preoperative ROM of the AS group and PS group were no significance(P>0.05).No significant differences in postoperative KSS clinical,postoperative KSS functional and postoperative KSS scores between the two groups of patients at the 1st,3rd,and 12th months(P>0.05).ROM in the 1st and 3rd months of the two groups were(107.30±6.52)°and(110.23±9.54)°,(118.52±8.45)°and(119.0°±6.13)°,and the differences were not statistically significant(P>0.05),the ROM at the 12th months were(119.39±7.01)°and(123.85±6.52)°,the PS group was higher than the AS group and the difference was statistically significant(P<0.05).The VAS at 1st,3rd,and 12th months were 1(0,1)and 1(1,2),0(0,1)and 1(0,1),0(0,1),and 0(0,1),the difference was not statistically significant(P>0.05).The 12th months outcomes were significantly improved compared with preoperative outcomes(P<0.05),and no complications were found after surgery.The two groups of patients in the gait analysis at 1st,3rd,and 12th months after surgery of maximum external rotation angle,maximum internal rotation angle,maximum external flip angel,maximum internal flip angel,maximum flexion angle,maximum extension angle,maximum anterior displacement,maximum posterior displacement,maximum proximal displacement,maximum distal displacemen,maximum external displacement,maximum internal displacement were no significant difference(P>0.05).Conclusion:Both AS group and PS group achieved good clinical results in the early postoperative period.At the same time,the AS insert avoids the loss of bone mass caused by femoral intercondylar osteotomy,which is conducive to possible future revisions.The design of the cam-post of the PS insert allows patients to obtain higher ROM.Without preserving PCL,We summarize the following references for prosthesis selection:for patients with relatively short stature,osteoporosis and low functional requirements,we consider the use of AS insert,and for patients with relatively tall stature,good bone condition and high functional requirements,we consider the choice of PS insert. |
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