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BACKGROUND:For the patients who have undergone unicompartmental knee arthroplasty,although the surgical effect is clear,there is still a lack of effective quantitative evaluation tools,and it is necessary to further explore the early postoperative gait and stability changes. OBJECTIVE:To investigate the changes in gait and stability before and after unicompartmental knee arthroplasty. METHODS:From May 2021 to May 2022,30 patients aged(63.80±9.31)years who planned to perform unilateral unicompartmental knee arthroplasty in the Department of Joint Surgery,Affiliated Hospital of Xuzhou Medical University were selected as the unicompartmental knee arthroplasty group.15 healthy elderly patients aged(61.28±8.60)years without a history of hip and knee pain and hip and knee joint dysfunction were recruited as the control group.Hospital for special surgery scores,stability parameters(center of pressure path length,95%confidence ellipse area)and gait parameters(pace,stride length,stride frequency,gait cycle,and the proportion of single support period)were recorded and compared in the control group and unicompartmental knee arthroplasty group before operation,1 and 3 months after operation. RESULTS AND CONCLUSION:(1)There was no significant difference in the step frequency between the patients 1 month after operation and those before operation in the unicompartmental knee arthroplasty group(P＞0.05).The stability of 1 month after operation was worse than that before operation,and other parameters of 1 month after operation were better than those before operation,and the difference was statistically significant(P＜0.05).(2)Hospital for special surgery score,gait and stability parameters at 3 months after operation were better than those before operation(P＜0.05).(3)Compared with the control group,the pace,stride length,stride frequency,and the proportion of single support period of the unicompartmental knee arthroplasty group were significantly lower before and 3 months after operation.Center of pressure path length,95%confidence ellipse area and gait cycle were greater in the unicompartmental knee arthroplasty group than those in the control group,with statistically significant differences(P＜0.05).(4)It is indicated that gait analysis is an effective means to quantitatively evaluate the rehabilitation status after unicompartmental knee arthroplasty.The early gait recovery after unicompartmental knee arthroplasty is good,but the gait frequency improvement is not obvious and the stability is poor 1 month after the operation.
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Objective To analyze the predictive value of preoperative C-reactive protein(CRP)to albumin(Alb)ratio(CRP/Alb)for postoperative mortality within 1 year in elderly patients(≥ 80 years)with hip fracture.Methods The medical records of 401 patients aged ≥80 years who underwent surgical treatment for hip fracture in Affiliated Hospital of Xuzhou Medical University from January 2017 to December 2019 were retrospectively analyzed.There were 134 males and 267 females.The age was 80-99 years,and the aver-age age was 85.27±4.02 years.The mortality of the patients 1 year after operation was calculated by telephone follow-up or outpatient reexamination,the patients were divided into survival group(314 cases)and death group(87 cases).Factors that may affect patient sur-vival,including age,gender,operation mode,fracture type,American Society of Anesthesiology(ASA)grade,number of preoperative medical complications and preoperative laboratory indicators,including red blood cell count,white blood cell count,platelet count,hemo-globin,CRP and Alb were collected,and the CRP/Alb was calculated.Univariate analysis was performed for the above factors,and then the factors with statistically significant differences were further included in multivariate Logistic regression analysis,and area under the curve(AUC)of CRP,Alb and CRP/Alb were compared.Results A total of 401 patients in the group,87 patients died within 1 year after operation,the mortality rate was 21.70％.Univariate analysis showed that age,ASA grade,number of preoperative medical compli-cations,hemoglobin,white blood cell count,CRP,Alb,and CRP/Alb were the risk factors for death within 1 year after operation in eld-erly patients with hip fracture.Multivariate Logistic regression analysis showed that CRP,Alb,CRP/Alb,age,ASA grade and the num-ber of medical complications were independent risk factors for death within 1 year after operation in elderly patients with hip fracture(OR were 1.016,0.918,1.603,1.095,2.915,3.371,P＜0.05).The AUC of CRP,Alb and CRP/Alb for predicting postoperative death within 1 year in elderly patients with hip fracture were 0.783,0.719 and 0.814,respectively.Conclusion Compared with CRP and Alb,CRP/Alb is more valuable in predicting postoperative death in elderly patients(≥ 80 years)with hip fracture.