Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.
BMC Musculoskelet Disord. 2020 Jun 29;21(1):409. doi: 10.1186/s12891-020-03457-1.
Whether using the scalpel can provide better and faster recovery after the primary total knee arthroplasty (TKA) is still controversial. The aim of this research was to compare the clinical outcomes of using the scalpel and the electric cautery in primary TKA.
From January 2016 to December 2017, a retrospective cohort study was conducted in 313 patients who underwent unilateral primary TKA by using the scalpel (group S). During this period, we selected 313 patients who underwent unilateral primary TKA by using the electric cautery (group E) for comparison. The tourniquet time, operative time, blood loss, wound complications, visual analog score for pain, range of motion, Knee Society Score were assessed between the two groups. The Forgotten Joint Score was used to analyze the ability to forget the joint.
There were no significant differences in tourniquet time, operative time, blood loss between the two groups (p > 0.05). In the group S, the visual analog score for pain, range of motion, Knee Society Score were found better results at 1 week, 1 month, 3 months, 6 months, 12 months and 24 months after surgery (p < 0.05). Besides, during the follow-up period, the Forgotten Joint Score was significantly higher compared with group E (p < 0.05).
In this research, the patients who underwent TKA by using the scalpel could achieve better clinical outcomes. In addition, if forgotten artificial joint after TKA was the final goal, the patients who underwent TKA by using the scalpel would acquire better quality of life.
在初次全膝关节置换术(TKA)后使用手术刀是否能提供更好、更快的恢复仍然存在争议。本研究的目的是比较使用手术刀和电刀进行初次 TKA 的临床效果。
本回顾性队列研究纳入了 2016 年 1 月至 2017 年 12 月间接受单侧初次 TKA 的 313 例患者(使用手术刀组,S 组)。在此期间,我们选择了同期接受单侧初次 TKA 的 313 例患者(使用电刀组,E 组)进行比较。比较两组患者的止血带时间、手术时间、失血量、伤口并发症、疼痛视觉模拟评分(VAS)、关节活动度、膝关节学会评分(KSS)。采用遗忘关节评分(FJS)分析关节遗忘能力。
两组患者的止血带时间、手术时间、失血量差异均无统计学意义(p>0.05)。S 组患者在术后 1 周、1 个月、3 个月、6 个月、12 个月和 24 个月时 VAS、关节活动度、KSS 评分均明显更好(p<0.05)。随访期间,FJS 评分明显高于 E 组(p<0.05)。
在本研究中,使用手术刀进行 TKA 的患者可获得更好的临床效果。此外,如果 TKA 后忘记人工关节是最终目标,那么使用手术刀进行 TKA 的患者将获得更好的生活质量。