QS微创全膝关节置换术的早期疗效观察  

Short-term clinical outcome of quadriceps sparing total knee arthroplasty

作　　者：何森[1] 曹文[1] 李刚[1] 牛福藤[1] 郭峰[1] 孙磊[1] 

机构地区：[1]中国医学科学院中国协和医科大学生物医学工程研究所,天津300192

出　　处：《第三军医大学学报》2007年第23期2283-2285,共3页Journal of Third Military Medical University

摘　　要：目的检查QS微创全膝关节置换术早期的临床效果。方法选取自2005年9月至2006年12月,本科行QS微创全膝关节置换术20例25膝为QS组,年龄59～82岁,平均68岁,女性患者15例(19膝),男性5例(6膝)。手术前诊断骨性关节炎18例,类风湿性关节炎2例。选取本科同期同等条件患者22例(25膝)作为对照组。对照组行传统的标准全膝关节置换术。检测2组手术前后KSS评分、主观无痛时间、出血量、手术切口长度、术后完全负重行走时间,评价两组手术效果。结果无一例失访。随访时间4～19个月,平均12个月。QS组手术前KSS评分(58.0±4.1)分,手术后1周达到(93.0±1.2)分;手术切口长度为(10.0±1.1)cm;平均出血量为600ml。最后随访时患者无感染、下肢深静脉栓塞、假体周围骨折、假体松动、血管神经损伤和脱位等并发症发生。结论QS微创全膝关节置换术不破坏股四头肌和伸膝装置,与传统全膝关节置换术相比具有出血少、疼痛缓解和功能康复迅速等优点,早期临床效果良好,其成功关键在于选择理想的患者和手术技术的精益求精。Objective To investigate the early clinical effectiveness after quadriceps sparing total knee arthroplasty. Methods From September 2005 to December 2006, quadriceps sparing total knee arthroplasty in 25 knees was performed for 20 patients （5 males, 6 knees; 15 females, 19 knees）. The patients aged 59 to 82 years （average 68 years）. The diagnosis was osteoarthritis in 18 patients, rheumatoid arthritis in 2. Standard total knee arthroplasty in 25 knees was performed for 22 patients in the same period, as control. Results All the patients were followed up from 4 to 19 months with the average of 12 months. The KSS knee score improved from preoperative （58.0 ±4.1 ） to postoperative （93.0 ±1.2） in QS group. The average length of operative incision was 10 cm （range 9 to 12 cm）. The average blood loss was 600 ml. No infections, deep venous embolism of lower limb, fractures, loosening of the prostheses, injury of blood vessels and nerves, or dislocations were found in all patients at the last follow-up. Conclusion By avoiding injury to the quadriceps muscle groups and the extensor mechanism, quadriceps sparing total knee arthroplasty had the advantages of less postoperative pain, less blood loss, and earlier functional recovery in comparison with traditional total knee arthro- plasty. The initial clinical result was excellent. The key to successful clinical outcome is optimizing patient selection and paying specific attention to operative details.

关 键 词：微创外科 全膝关节置换术 股四头肌保护 关节活动度 “移动窗口”技术 

分 类 号：R684[医药卫生—骨科学] R687.4[医药卫生—外科学]