双侧全膝关节置换术对膝关节骨关节炎患者膝关节功能及TGF-β1表达的影响

Effect of Bilateral Total Knee Arthroplasty on Knee Function and TGF-β1 Expression in Patients with Knee Osteoarthritis

目的:探讨双侧全膝关节置换术治疗膝关节骨关节炎的临床效果。方法:选取2020年1月-2021年12月在大冶市人民医院治疗的膝关节骨关节炎患者110例,根据治疗方案分为A组(n=60)和B组(n=50),其中A组给予同期双侧全膝关节置换术,B组给予分期双侧全膝关节置换术,观察两组手术时间等指标,检测膝关节液转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)。结果:A组手术时间和住院时间分别为(210.02±43.30)min和(18.28±5.21)d,均明显短于B组(P<0.05);A组术后引流量为(410.20±43.30)mL,明显多于B组(P<0.05)。术后1个月,A组TGF-β1为(15.50±2.00)pg/mL,明显高于B组(P<0.05),而TNF-α为(48.93±12.21)pg/mL,明显低于B组(P<0.05)。术后6个月,A组HSS评分和膝关节活动度分别为(92.20±5.53)分和(113.40±23.02)°,均明显高于B组(P<0.05),而WOMAC评分为(23.30±9.82)分,明显低于B组(P<0.05)。术后6个月,A组ADL评分为(82.11±10.34)分,明显高于B组(P<0.05)。结论:应用双侧全膝关节置换术治疗膝关节骨关节炎有较好的效果,可改善关节液TGF-β1、TNF-α水平,其中同期双侧全膝关节置换手术较好。

Objective:To investigate the clinical effect of bilateral total knee arthroplasty in the treatment of knee osteoarthritis.Method:A total of 110 patients with severe knee osteoarthritis treated in Daye People's Hospital from January 2020 to December 2021 were selected and divided into group A(n=60)and group B(n=50)according to the treatment plan.Group A was given simultaneous bilateral total knee arthroplasty,and group B was given staged bilateral total knee arthroplasty.The operation time and other indicators of the two groups were observed,and the knee joint fluid transforming growth factor-β1(TGF-β1)and tumor necrosis factor-α(TNF-α)were detected.Result:The operation time and hospitalization time of group A were(210.02±43.30)min and(18.28±5.21)d,which were significantly shorter than those in group B(P<0.05);the postoperative drainage volume of group A was(410.20±43.30)mL,which was significantly higher than that of group B(P<0.05).One month after operation,TGF-β1 in group A was(15.50±2.00)pg/mL,which was significantly higher than that in group B(P<0.05),while TNF-αwas(48.93±12.21)pg/mL,which was significantly lower than that in group B(P<0.05).Six months after operation,the scores of HSS and knee joint mobility in group A were(92.20±5.53)scores and(113.40±23.02)°,respectively,which were significantly higher than those in group B(P<0.05),while WOMAC score was(23.30±9.82)scores,which was significantly lower than that in group B(P<0.05).Six months after operation,the ADL score of group A was(82.11±10.34)scores,which was significantly higher than that of group B(P<0.05).Conclusion:The application of bilateral total knee arthroplasty has a good effect on the treatment of knee osteoarthritis,can improve the levels of joint fluid TGF-β1 and TNF-α,and the simultaneous bilateral total knee arthroplasty is better.