高屈曲度假体与全髁型假体早期临床疗效比较  

Comparison of Hi-flexion and Total Condylar Prosthesises in Total Knee Arthroplasty Preliminary Clinical Results

作　　者：翁习生[1] 王炜[1] 高增鑫[1] 黄志峰[1] 盛林[1] 邱贵兴[1] 

机构地区：[1]北京协和医院骨科,北京100730

出　　处：《实用骨科杂志》2007年第1期25-27,共3页Journal of Practical Orthopaedics

摘　　要：目的 对比高屈曲度假体与传统全髁型假体全膝关节表面置换术后早期临床效果的差异。方法 选取2004年10月至2005年10月间50例（67个膝关节）接受全膝关节表面置换术的膝骨关节炎患者，随机分为A组（高屈曲度假体组，使用LPS—Flex假体）和B组（全髁型假体组／TTC组，使用PFC∑及GⅡ假体）。A组包括26例患者（32个膝关节），男5例，女21例，平均年龄（65．29±5．96）岁。B组包括24例患者（35个膝关节）。男4例，女20例，平均年龄（64．32±8．32）岁。平均随访时间为1年8个月（1～2年）。结果 术前HSS评分为A组（58．61±11．40）分，B组（55．73±13．42）分，两组间无显著差异；术前膝关节活动度为A组（92±12．6）。（-15°～110°），B组（95±11．8）。（-15°～115°），两组间无显著差异。术后末次随访时HSS评分为A组（91．42±6．1）分，B组（92．67±6．33）分，两组间无显著差异；膝关节活动度为A组（124．68±10．32）。（-5°～137°），B组（102．56±15．44）。（-5°～118°），两组间有显著差异，A组患者膝关节屈曲功能明显优于B组。术后并发症包括：A组1例双膝全膝关节置换患者术后3个月时右膝关节感染，1例患者术后深静脉血栓形成；B组1例单膝全膝关节置换患者术后2周伤口脂肪液化，2例患者术后发生深静脉血栓。结论 全膝关节置换术中使用高屈曲度假体与使用传统全髁型假体相比，在改善患者疼痛、恢复行走功能以及手术并发症率方面无显著差别，但术后所能达到的屈曲度有显著差异。Objective To evaluate the early results of total knee arthroplasty using high flexion prosthesis,comparing with traditional total condylar prosthesis. Methods This study reviewed 50 patients （67 knees） with osteoarthritis underwent total knee arthroplasty between October 2004 and October 2005. Patients were randomized to group A （high flexion group,using LPS-Flex） and group B （total condylar group,using PFC∑ or G Ⅲ. There are 26 patients （32 knees） in group A,includes 5 male patients and 21 females. The average age of group A is 65.29±5.96. There are 24 patients （35 knees） in group B,includes 4 male patients and 20 females. The average age of group B is 64. 32±8. 32. The average follow-up time of both groups is one year and eight months,ranging from one year to two years. Results There is neither significant difference between preoperative HSS score of group A （58. 61 ± 11.40） and group B （55.73± 13.42）,nor the preoperative range of motion between group A （92°±12.6°） and group B （95°± 11.8°）. There is no significant difference between postoperative HSS score between group A and group B,but the postoperative range of motion of group A is significantly higher than that of group B. Complications in group A include one late infection and one deep vein thrombosis （DVT）. Complications in group B include one wound problem of delayed union and two DVT. Conclusion There is significant improvement in postoperative range of motion rising high flexion prosthesis compared with total condylar prosthesis,but not in pain relieves,locomotor activity and complications.

关 键 词：高屈曲度 全髁型膝关节 全膝关节置换术 比较 

分 类 号：R687.42[医药卫生—骨科学]