Effect of Individualized Distal Femoral External Rotation Osteotomy Total Knee Arthroplasty on Joint Function and Rehabilitation Outcomes in Patients with Knee Osteoarthritis
Objective To explore the effect of individualized distal femoral external rotation osteotomy total knee arthroplasty(TKA)on knee function and rehabilitation outcomes in patients with knee osteoarthritis(KO A).Methods A total of 98 patients with KO A treated in our hospital from March 2021 to March 2022 were selected and randomly divided into two groups according to a random number table method,with 49 cases in each group.The control group received conventional TKA treatment,while the study group received individualized distal femoral external rotation osteotomy TKA treatment.The perioperative conditions of the two groups were compared,as well as the New York Hospital for Special Surgery knee score(HSS),American Knee Society score(KSS),joint range of motion,matrix metalloproteinase-9(MMP-9)in joint fluid,soluble intercellular adhesion molecule-1(sICAM-1),tumor necrosis factor-α(TNF-α)in joint fluid,and other rehabilitation effect-related indicators such as the mechanical axis lateral angle of the distal femur(mLDFA)and the lower limb mechanical axis angle(HKA)in the coronal plane,as well as the percentage of support time,stride length,pace,and other gait parameters.The visual analogue scale(VAS)score for pain and arthritis quality of life measurement scale 2(AIMS2)score were also compared.The postoperative complications of the two groups were also compared.Results The follow-up time of both groups was more than 6 months,and there were no lost cases.The hospitalization time of the study group was shorter than that of the control group[(6.24±1.18)days vs.(7.36±1.05)days],and the difference was statistically significant(P＜0.05).The incidence of complications in the study group after surgery(6.12％)was not significantly different from that in the control group(10.20％)(P＞0.05).Both groups showed improvement in various indicators after surgery,and the HSS score,KSS stability score,and joint range of motion of the study group were higher,the coronal mLDFA and HKA were lower,the percentage of support time,pace,and stride length were higher,the VAS score and AIMS2 score were lower than those of the control group at 3rd and 6th month after surgery(all P＜0.05).At 3rd month after surgery,the levels of TNF-α,sICAM-1,and MMP-9 in joint fluid in both groups were lower than those before surgery(P＜0.05),but there was no significant difference between the groups(P＞0.05).Conclusion Compared with conventional TKA treatment,individualized distal femoral external rotation osteotomy TKA treatment can reduce the levels of TNF-α,sICAM-1,and MMP-9 in joint fluid,improve joint alignment parameters,enhance knee function,adjust gait parameters,reduce postoperative pain,and improve patients'quality of life after surgery.
NETL
NSTL
万方数据
