[Clinical affect of contralateral knee pain on patients undergoing total knee arthroplasty].

OBJECTIVE: To evaluate the effect of contralateral knee pain on joint dysfunction and treatment satisfaction on the operative side 1 year after total knee arthroplasty（TKA） in patients with osteoarthritis. METHODS: From March 2019 to January 2021, 635 patients underwent TKA including 296 males and 339 females, with an average age of （69.33±9.38） years old, the duration of symptoms was （1.15±0.44） years. According to the degree of pain visual analogue scale（VAS） in the contralateral knee joint 12 months after operation, the patients were divided into three groups, 423 patients with no or mild pain（VAS 0 to 3）, 105 patients with moderate pain（VAS 4 to 6）, 107 patients with severe pain（VAS 7 to 10）. The related factors of knee function and satisfaction score 12 months after operation were analyzed and compared on different contralateral knee pain levels. RESULTS: The contralateral knee pain VAS was significantly reduced after TKA. Old age, high body mass index, high WOMAC scores of postoperative knee joint, moderate and severe pain of contralateral knee joint were the risk factors of dissatisfaction （P<0.05）, OR were 1.285, 1.665, 2.319, 1.863 respectively. The high degree of knee pain on the operation side and the ladder room in the home environment were the risk factors for the high WOMAC scores 1 year after discharge（P<0.05）. Adherence to exercise and functional training after discharge were the protective factors for patients with high WOMAC scores 1 year after discharge（P<0.05）, OR were 3.016, 1.738, 0.619, 0.574 respectively. CONCLUSION: TKA can alleviate the pain of contralateral knee joint. Contralateral knee pain does not affect the WOMAC scores after TKA, but it will reduce the treatment satisfaction of patients.

[Influence of hemoglobin level(Hb) on survival and prognosis of elderly hip fracture at admission].

OBJECTIVE: To analyze the relationship between hemoglobin(Hb) level on admission and survival prognosis of patients with hip fracture. METHODS: From February 2016 to October 2018, 249 elderly patients with hip fracture were surgically treated including 62 males and 187 females;the age ranged from 60 to 91(73.67±10.52) years;the time from injury to operation was (6.79±2.27) d. The clinical and laboratory examination results were collected. The Hb level at admission and the mortality at 30, 90, 180 and 360 days after operation were observed. According to the Hb level at admission, the patients were divided into Hb<120 g/L and Hb≥120 g/L groups. The survival conditions of the two groups at 30, 90, 180 and 360 days after operation were compared and analyzed. Logistic regression was used to analyze the effect of Hb level on death 30, 90, 180 and 360 days after operation. RESULTS: The mortality rates at 30, 90, 180 and 360 days after operation were 5.22%, 9.24%, 16.87% and 20.48% respectively. The level of Hb at admission was a risk factor for prognosis and death 30, 90, 180 and 360 days after operation(P<0.05). The OR(95% CI) were 2.431(1.475-4.006), 2.625(1.468-4.695), 2.276(1.320-3.925) and 2.082(1.221-3.551) respectively. CONCLUSION: The level of Hb at admission can affect the survival and prognosis of elderly patients with hip fracture. We should further study how to manage the level of Hb before operation.