Comparison of the Efficacy of Three Treatment Methods for Advanced Osteoarthritis of the Knee

Objective: To compare, analyze and evaluate the clinical efficacy of the combination of Total knee arthroplasty (TKA) only, TKA with anti-osteoporosis medicine, and KOA with anti-osteoporosis for the patients with severe osteoarthritis and osteoporosis.

Methods: A retrospective study was conducted Between September 2019 and April 2021; 90 patients with advanced Osteoarthritis or rheumatoid arthritis 60 of them underwent total knee arthroplasty. The total patients were divided into three groups based on the treatment options: 30 patients underwent total knee arthroplasty (TKA)only, and another 30 patients had undergone total knee arthroplasty (TKA) with anti-osteoporosis medicine (calcium, VitD3, Elcatonin, Diacerein) for treatment. In contrast, the last 30 patients with KOA treat only with anti-osteoporosis medicine. The clinical efficacy parameters of the three groups (age, sex, hospital duration, BMI, Serum β-ctx, Serum vitamin D3, Serum N-mid, HSS score, Vas score) were compared using Spss 26.0 statistical software for statistical analysis. The measured data were expressed as mean ± standard deviation (x^-±s). Categorical data were tested by chi-square test, data obeying normal distribution by t-test, and data not obeying normal distribution by rank-sum test. The p-value for the test level was 0.05, <0.05 differences were statistically significant.

Results: Mean age of patient were 65.13 ±6.47 in the Total knee arthroplasty (TKA) only 

group and 67.73±8.01 years in the Total knee arthroplasty (TKA) with anti-osteoporosis medicine group, 67.5±6.64 years in KOA with anti-osteoporosis group there was no statistically difference mean age between three groups P>0.05. Patients with Total knee arthroplasty (TKA) with anti-osteoporosis medicine group demonstrate shorter hospital stay duration, higher HSS score, shorter VAS score, while the TKA with anti-osteoporosis and KOA with anti-osteoporosis demonstrate higher serum vitamin D3, lower serum β-ctx, serum N-mid level, BMD, than Total knee arthroplasty (TKA) only group. There was no statistically significant difference regarding BMI P<0.05

Conclusion: The treatment efficacy of the combination of Total knee arthroplasty (TKA) with anti-osteoporosis and KOA with anti-osteoporosis drug than only Total knee arthroplasty (TKA) treatment for end-stage, posttraumatic Osteoarthritis is more advantageous, safest and precise, which is worth being applied in clinical practice.