RESUMEN
Objective@#To observe and evaluate the mechanism and clinical values of Total Knee Arthroplasty in treating the patients with severe knee osteoarthritis.@*Method@#To review and analyse 74 patients with severe knee osteoarthritis who were treated in Suzhou Atliliated Hospital of Nanjing Medical College, including 34 male patients and 40 female patients with average aged (58.22±3.24)ranging from 47 to 75. All the patients received TKA. Compared the HSS score, WOMAC and content of TNF-α and IL-1β in knee synovial fluid 3 months before the operation, 3 months after the operation and 6 months after the operation. SPSS20.0 software was used for statistical analysis, and ANOVA or nonparametric test was used for comparison among groups of data.@*Results@#HSS scores measured at 3 months after the operation[(58.30±6.33)vs (31.31±15.92)] and 6 months after the operation[(72.39±6.68)vs (31.31±15.92)] were better than those measured before the operation, which proved a statistical difference (P<0.05). WOMAC measured 3 months after the operation and 6 months after the operation were better than those measured before the operation[(31.068±6.771)vs (67.014±7.699); (24.216±5.224) vs (67.014±7.699), all P<0.05]. TNF-α in knee synovial fluid measured 3 months after the operation and 6 months after the operation were lower than those measured before the operation [(56.182±7.056)pg/ml vs(85.065±6.666)pg/ml; (30.387±4.194)pg/ml vs (85.065±6.666)pg/ml; all P<0.05]. IL-1β measured at 3 months after the operation and 6 months after the operation were lower than those measured before the operation [(21.411±4.751) pg/ml vs (60.305±6.932)pg/ml; (11.578±4.142) pg/ml vs (60.305±6.932) pg/ml; P<0.05]. Compared with the data at 3 months after the operation, the content of TNF-α [(30.387±4.194)pg/ml vs (56.182±7.056)pg/ml] and IL-1β[(11.578±4.142)pg/ml vs (21.411±4.751)pg/ml] were both lower, which proved a statistical difference (P<0.05).@*Conclusion@#TKA can imporve the joint functions and activities of the patients with severe knee osteoarthritis and lower the the inflammatory factor like TNF-α and IL-1β in knee synovial fluid to relief the pain of the patiences and accelerate the process of recovery.
RESUMEN
Objective To observe and evaluate the mechanism and clinical values of Total Knee Arthroplasty in treating the patients with severe knee osteoarthritis.Method To review and analyse 74 patients with severe knee osteoarthritis who were treated in Suzhou Atliliated Hospital of Nanjing Medical College,including 34 male patients and 40 female patients with average aged (58.22 ± 3.24)ranging from 47 to 75.All the patients received TKA.Compared the HSS score,WOMAC and content of TNF-α and IL-1β in knee synovial fluid 3 months before the operation,3 months after the operation and 6 months after the operation.SPSS20.0 software was used for statistical analysis,and ANOVA or nonparametric test was used for comparison among groups of data.Results HSS scores measured at 3 months after the operation [(58.30 ± 6.33)vs (31.31 ± 15.92)] and 6 months after the operation[(72.39 ± 6.68) vs (31.31 ± 15.92)] were better than those measured before the operation,which proved a statistical difference (P ＜ 0.05).WOMAC measured 3 months after the operation and 6 months after the operation were better than those measured before the operation [(31.068 ± 6.771) vs (67.014 ± 7.699);(24.216 ±5.224) vs (67.014 ±7.699),all P ＜0.05].TNF-α in knee synovial fluid measured 3 months after the operation and 6 months after the operation were lower than those measured before the operation [(56.182 ± 7.056) pg/ml vs (85.065 ± 6.666) pg/ml;(30.387 ± 4.194) pg/ml vs (85.065 ± 6.666) pg/ml;all P ＜ 0.05].IL-1β measured at 3 months after the operation and 6 months after the operation were lower than those measured before the operation [(21.411 ± 4.751) pg/ml vs (60.305 ± 6.932) pg/ml;(11.578 ± 4.142) pg/ml vs (60.305 ± 6.932) pg/ml;P ＜ 0.05].Compared with the data at 3 months after the operation,the content of TNF-α [(30.387 ±4.194)pg/ml vs (56.182 ±7.056) pg/mll and IL-1β[(11.578 ±4.142) pg/ml vs (21.411 ± 4.751)pg/ml] were both lower,which proved a statistical difference (P ＜ 0.05).Conclusion TKA can imporve the joint functions and activities of the patients with severe knee osteoarthritis and lower the the inflammatory factor like TNF-α and IL-1β in knee synovial fluid to relief the pain of the patiences and accelerate the process of recovery.
RESUMEN
Over recent years,pedicle screw fixation is widely used in spine surgery,which allows 3-dimensional fixation with a more rigidconstruct and permits a shorter fusion length.However,its fixationeffect is not so good for patients with severe osteoporosis.Cortical bone trajectory screw insertion has been advocated because it is reportedly less invasive,improvesscrew-bone purchase and reduces neurovascular injury.Based on the present evidence,the author evaluates the relative advantages of cortical bone channels.To this end,a search of relevant published studies reporting biomechanical,morphemetricor clinical outcomes after using of cortical bone trajectory screws in patients with spinal pathologies is reviewed.