Objective To assess the clinical effects of the cement-screw technique and preoperative prehabilitation in primary total knee arthroplasty for tibial plateau bone defects.Methods A total of 51 patients(64 knees)who underwent primary total knee arthroplasty from January 2022 to June 2023 were included.The tibial plateau bone defects were repaired using the ce-ment-screw technique.The control group consisted of 22 patients(28 knees)who received preoperative health education accord-ing to consensus guidelines,while the observation group included 29 patients(36 knees)who completed a standardized prehabili-tation program for 4 weeks in addition to the control group's education.The operation time,number of screws used,postoperative drainage volume,time to first mobilization,recovery time of quadriceps strength,duration of walker use,as well as visual analog scale(VAS)pain scores,range of motion(ROM)of the knee joint,and hospital for special surgery(HSS)knee function scores 1 day and 3 months postoperatively were compared between the two groups.Results All 51 patients were followed up for a peri-od of 12 to 32 months,with an average follow-up of 24.2 months.No complications such as deep infection,deep vein thrombo-sis,bone resorption,prosthetic loosening,periprosthetic fracture,or screw breakage occurred during the follow-up period.There were no statistically significant differences in operation time,number of screws used,and post-operative drainage volumes be-tween the observation and control groups(P＞0.05).However,the observation group had a shorter time to first mobilization,re-covery time of quadriceps strength,and duration of walker use compared to the control group,with statistically significant differ-ences(P＜0.05).The VAS pain scores on the day before surgery and at 3 months after surgery in the observation group were low-er than those in the control group,while the knee ROM and HSS knee function scores on the day before surgery and at 3 months after surgery were higher in the observation group,with statistically significant differences(P＜0.05).Conclusion The use of the cement-screw technique to repair tibial plateau bone defects during complex primary total knee arthroplasty is safe and reli-able.Appropriate and effective preoperative prehabilitation training can accelerate post-operative recovery and improve short-term outcomes.
Total knee arthroplastyTibial plateau bone defectCementScrewPrehabilitation management
万方数据
维普
