Zhonghua wai ke za zhi [Chinese journal of surgery]
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Zhonghua Wai Ke Za Zhi · Jun 2020
Comparative Study[Comparison of the early efficacy of unicompartmental and total knee arthroplasty in patients with medial compartmental osteoarthritis of the knee: a propensity score matching study].
Objective: To compare the short-term efficacy of unicompartmental knee arthroplasty (UKA) and total knee arthroplasty(TKA) in the treatment of medial compartmental knee osteoarthritis. Methods: A retrospective analysis was performed on 197 patients with medial compartment osteoarthritis of the knee treated by the same group of doctors from January 2015 to December 2018. There were 86 males and 111 females, aged (67.7±10.5) years (range: 46 to 92 years), among which 101 cases received UKA and 96 cases received TKA. ⋯ There was no significant difference in the time of surgical tourniquet, range of motion, American knee society clinical score and incidence of deep vein thrombosis in lower extremities between the two groups. No complications such as surgical site infection, prosthesis loosening and dislocation occurred in the two groups. Conclusion: The early effect of UKA is similar to that of TKA, and it is better than TKA in the aspects of knee clunk or crepitus, forgotten joint score, blood loss, opioid dosage and postoperative hospital stay.
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Zhonghua Wai Ke Za Zhi · Jun 2020
[The influence of patellofemoral joint degeneration on outcome of Oxford medial unicompartmental knee arthroplasty].
Objective: To explore the influence of lateral patellofemoral joint degeneration on the treatment of anteromedial osteoarthritis of knee joint by Oxford medial unicompartmental knee arthroplasty. Methods: The clinical data of 73 patients (73 knees) with knee osteoarthritis underwent unicompartmental knee arthroplasty at Department of Orthopaedic Surgery, Xuanwu Hospital, Capital Medical University from March 2016 to December 2017 were analysed respectively. There were 18 males and 55 females, aged (68.6±7.5) years(range: 53 to 89 years). ⋯ The HSS score increased from 57.7±11.8 preoperative to 81.8±7.8 postoperative (t=16.64, P=0.00) and WOMAC osteoarthritis index decreased from 48.9±13.4 preoperative to 15.6±8.8 postoperative (t=20.48, P=0.00). There was no statistical difference in the change of HSS between the degenerative group and the non-degenerative group before and after surgery(27.5±12.2 vs. 22.5±12.3, t=-1.65, P=0.10) as well as the change of WOMAC osteoarthritis index(31.8±14.0 vs. 36.4±13.7, t=-1.35, P=0.18), but the lateral patellofemoral joint degeneration was related to inability to complete squats (χ(2)=5.17, P=0.04) and sitting up (χ(2)=7.22, P=0.01). Conclusion: The degeneration of lateral patellofemoral joint has no effect on the early functional recovery of patients with anteromedial knee osteoarthritis after Oxford medial unicompartmental knee arthroplasty.
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Zhonghua Wai Ke Za Zhi · Jun 2020
[Diagnostic value of D-dimer for chronic periprosthetic infection after hip and knee joint replacement].
Objective: To investigate the diagnose value of D-dimer for chronic periprosthetic infection (PJI) after hip and knee arthroplasty. Methods: A retrospective analyze was conducted on 168 patients underwent revision arthroplasty and primary arthroplasty at the First Affiliated Hospital of Xinjiang Medical University from November 2017 to December 2018. There were 58 males and 110 females, aged(58.6±14.5)years. ⋯ ROC analysis showed that the optimum cutoff value of D-dimer in the diagnosis of chronic PJI was 370.5 μg/L, the sensitivity was 90.5%, the specificity was 84.1%; the optimum cutoff value of CRP was 9.3 mg/L, the sensitivity was 95.2%, the specificity was 90.9%, the optimum cutoff value of ESR was 33 mm/h, the sensitivity was 90.5%, and the specificity was 88.6%. The optimum cutoff value of D-dimer in the diagnosis of chronic PJI of hip joint is 294 μg/L, the sensitivity of diagnosis is 66.7%, the specificity is 77.6%; the optimum cutoff value of ESR is 45 mm/h, the sensitivity of diagnosis is 55.6% , the specificity is 97.4%; the optimum cutoff value of CRP is 8.1 mg/L, the sensitivity of diagnosis is 74.1%, the specificity is 84.2%. Conclusion: The value of D-dimer in the diagnosis of chronic PJI of knee joint is higher than that of hip joint, but the value of D-dimer in the diagnosis of chronic PJI is not better than ESR and CRP.