Safety of Total Knee Arthroplasty in the Treatment of Knee Osteoarthritis and Its Effect on Postoperative Pain and Quality of Life of Patients

Objective. To explore the safety of total knee arthroplasty (TKA) in the treatment of knee osteoarthritis (KOA) and its impact on patients’ postoperative pain and quality of life. Methods. A total of 60 KOA patients admitted to our hospital from January 2019 to January 2020 were selected as the research objects. The knee joint scores (HSS) before and after TKA were compared, and the patients’ quality of life was evaluated using the Osteoarthritis Index of Western Ontario and McMaster University (WOMAC). At the same time, the number of patients with complications was recorded, and the efficacy of TKA was comprehensively analyzed. Results. The postoperative HSS score was significantly higher than the preoperative score ( P < 0.05 ), the postoperative pain score increased with time, and the pain gradually decreased. The postoperative WOMAC score was significantly lower than the preoperative score ( P < 0.001 ), and the score at 6 months after surgery was significantly lower than that at 3 months after surgery ( P < 0.001 ). There were no complications such as severe prosthesis fracture, secondary sepsis, and patellar tendon rupture, and the total incidence of complications was 11.7%. The effective rate of treatment at 6 months after operation was 98.3%, which was significantly higher than that at 3 months after operation ( P < 0.05 ). Conclusion. Total knee arthroplasty can improve the knee joint function of patients with knee osteoarthritis, with low postoperative pain, low complication rate, and good quality of life for patients. It is worthy of promotion and application.

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Recognition of Factors of Postoperative Complications of Knee Osteoarthritis Patients and Comprehensive Nursing Intervention

Computational and Mathematical Methods in Medicine ◽

10.1155/2021/1840613 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Ying Dong ◽

Pei Zhang ◽

Lidan Fan

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Blood Loss ◽

Knee Joint ◽

Knee Osteoarthritis ◽

Knee Arthroplasty ◽

Nursing Intervention ◽

Joint Function ◽

Total Knee

Knee osteoarthritis (KOA) is a degenerative joint disease characterized by articular cartilage degeneration, cartilage exfoliation, osteophyte formation, and synovitis. It seriously affects the knee joint function and quality of life of patients. Total knee arthroplasty is now the most frequently used therapy for end-stage knee arthritis because it can successfully modify the line of lower extremities, restore knee joint function, alleviate pain, and enhance patients’ quality of life; nevertheless, it may cause significant trauma and bleeding. It can easily lead to infection and anemia. In this study, the control group chose total knee arthroplasty and the observation group chose total knee arthroplasty combined with PRP. The results showed that the knee joint function score, visual analog score, blood transfusion, total blood loss, total postoperative drainage, and complications in the observation group were superior to those in the control group. Total knee arthroplasty takes a long time and needs a lot of soft tissue incision, which leads to a lot of blood loss and can cause a variety of complications. Gel has been shown in studies to successfully decrease blood loss during and after total knee arthroplasty, enhance knee joint function recovery, and improve patient quality of life. In this paper, the complications and causes of knee osteoarthritis after total knee arthroplasty were studied. Combined with comprehensive nursing intervention for postoperative recovery, it helps to improve the formation of thrombin and calcium ion, which can effectively reduce blood loss, relieve pain, and promote the recovery of knee joint function. This study analyzed the application of total knee arthroplasty combined with gel in the treatment of knee osteoarthritis.

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Osteoarthritis of the knee joint. Etiology, treatment, rehabilitation (analytical review of the literature)

TRAUMA ◽

10.22141/1608-1706.3.22.2021.236317 ◽

2021 ◽

Vol 22 (3) ◽

pp. 5-11

Author(s):

Khaled Obeidat ◽

O.D. Karpinska

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Knee Joint ◽

Knee Replacement ◽

Knee Arthroplasty ◽

Gait Parameters ◽

Total Knee ◽

The Difference ◽

Knee Pathology

According to epidemiological studies, osteoarthritis accounts for 10–12 % of all cases of musculoskeletal diseases. In the general structure of knee pathology, degenerative diseases make up 57.8 %. The urgency of the problems of gonarthrosis is due to not only its widespread prevalence, but also the high risk of developing knee dysfunction, accompanied by a significant reduction in the quality of life of patients and often leading to partial or permanent disability of patients. Gonarthrosis has significant gender features. Women account for about 70 % of the number of patients, while men had this disease almost 2 times less often, but other data indicate that the incidence of gonarthrosis in men under 60 years of age is higher, and in women it begins to increase after 65 years. Knee replacement is a leading method in the treatment of knee osteoarthritis stages III–IV. The tendency towards an increase in the total number of surgeries leads to an increase in the frequency of complications and unsatisfactory results: according to some authors, from 3.3 to 13.2 % of patients complain of knee replacement outcomes. Studies of long-term complaints after arthroplasty have shown that in addition to pain reduction, some patients had an increase in varus angle when bending the knee while walking but they didn’t mark an improvement in gait parameters compared to preoperative examination. After unilateral total knee arthroplasty, the load patterns of the frontal plane in the operated knee remain pathological in the long run. After knee arthroplasty, there is muscle weakness, and studies have shown changes in all muscles of the lower extremity. Weakening of some muscles led to compensatory strengthening of others. Studies of the effect of preoperative rehabilitation on the outcome of knee arthroplasty have shown its low efficiency. Many studies have studied motor activity of patients after total knee arthroplasty in recent years. Not only gait features, but also movements of the pelvis, trunk and upper extremities are studied. Modern methods of diagnosing spatial oscillations of the body when walking have shown that disorders of body movements — excessive hand movements, pelvic loosening, asymmetrical flexion of the knee joints, etc., after arthroplasty are preserved in patients and restore slowly, and some disorders remain forever. Conclusions. Knee arthroplasty relieves pain, improves quality of life, but according to many authors, patients complain of incomplete restoration of the functionality of the prosthetic limb. According to the researchers, the main cause for incomplete reco-very of gait parameters is the difference in the frontal angles of the knee joint flexion and the difference in the length of the steps. Special training exercises can reduce the asymmetry of the steps, but it is difficult to completely restore the symmetry of the steps within 2 years. Studies of the effect of preoperative rehabilitation on the outcome of knee arthroplasty have shown its low effectiveness.

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Self-reported knee instability associated with pain, activity limitations, and poorer quality of life before and 1 year after total knee arthroplasty in patients with knee osteoarthritis

Journal of Orthopaedic Research® ◽

10.1002/jor.24023 ◽

2018 ◽

Vol 36 (10) ◽

pp. 2671-2678 ◽

Cited By ~ 3

Author(s):

Claudia S. Leichtenberg ◽

Thea P. M. Vliet Vlieland ◽

Herman M. Kroon ◽

Joost Dekker ◽

Willem Jan Marijnissen ◽

...

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Knee Osteoarthritis ◽

Knee Arthroplasty ◽

Knee Instability ◽

Activity Limitations ◽

Total Knee

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Effects of infrapatellar fat pad preservation versus resection on clinical outcomes after total knee arthroplasty in patients with knee osteoarthritis (IPAKA): study protocol for a multicentre, randomised, controlled clinical trial

BMJ Open ◽

10.1136/bmjopen-2020-043088 ◽

2020 ◽

Vol 10 (10) ◽

pp. e043088

Author(s):

Zhaohua Zhu ◽

Weiyu Han ◽

Ming Lu ◽

Jianhao Lin ◽

Zongsheng Yin ◽

...

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Knee Osteoarthritis ◽

Knee Arthroplasty ◽

Signal Intensity ◽

Ethics Committee ◽

Infrapatellar Fat Pad ◽

Fat Pad ◽

Total Knee

IntroductionThe infrapatellar fat pad (IPFP) is commonly resected during total knee arthroplasty (TKA) for better exposure. However, our previous studies have suggested that IPFP size was protective against, while IPFP signal intensity alteration was detrimental on knee symptoms and structural abnormalities. We hypothesise that an IPFP with normal qualities, rather than abnormal qualities, should be preserved during TKA. The aim of this study is to compare, over a 1-year period, the postoperative clinical outcomes of IPFP preservation versus resection after TKA in patients with normal or abnormal IPFP signal intensity alteration on MRI.Methods and analysisThree hundred and sixty people with end-stage knee osteoarthritis and on the waiting list for TKA will be recruited and identified as normal IPFP quality (signal intensity alteration score ≤1) or abnormal IPFP quality (signal intensity alteration score ≥2). Patients in each hospital will then be randomly allocated to IPFP resection group or preservation group. The primary outcomes are the summed score of self-reported Knee Injury and Osteoarthritis Outcome Score (KOOS), KOOS subscales assessing function in daily activities and function in sport and recreation. Secondary endpoints will be included: KOOS subscales (pain, symptoms and quality of life), Knee Society Score, 100 mm Visual Analogue Scale (VAS) Pain, timed up-and-go test, patellar tendon shortening, 100 mm VAS self-reported efficacy of reduced pain and increased quality of life, and Insall-Salvati index assessed on plain X-ray. Adverse events will be recorded. Intention-to-treat analyses will be used.Ethics and disseminationThe study is approved by the local Medical Ethics Committee (Zhujiang Hospital Ethics Committee, reference number 2017-GJGBK-001) and will be conducted according to the principle of the Declaration of Helsinki (64th, 2013) and the Good Clinical Practice standard, and in compliance with the Medical Research Involving Human Subjects Act . Data will be published in peer-reviewed journals and presented at conferences, both nationally and internationally.Trial registration numberThis trial was registered at Clinicaltrial.gov website on 19 October 2018 with identify number NCT03763448.

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