采用JOURNEY假体全膝关节置换术后近期临床疗效观察  

EARLY CLINICAL RESULTS OF TOTAL KNEE ARTHROPLASTY WITH JOURNEY PROSTHESIS

作　　者：周兵华[1] 唐康来[1] Hajo Thermann 王建[3] 杨会峰[1] 龚继承[1] 汪华清[1] 陈前博[1] 

机构地区：[1]第三军医大学附属西南医院骨科,重庆400038 [2]德国海德堡ATOS医院 [3]北京大学第三医院运动医学研究所

出　　处：《中国修复重建外科杂志》2009年第9期1030-1033,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的评价采用JOURNEY假体初次行全膝关节置换术(total knee arthroplasty,TKA)的近期临床疗效。方法对2006年9月-2007年5月德国ATOS医院采用JOURNEY假体行TKA的32例患者进行系统分析。男21例,女11例;年龄40～84岁,平均65.6岁。左膝13例,右膝19例。创伤性关节炎5例,骨性关节炎19例,类风湿性关节炎8例。患膝均伴疼痛,关节功能不同程度受限。MRI检查示患者均有不同程度软骨、半月板损伤,关节腔积液。病程1～4年,平均2.2年。术后第2天开始持续被动功能锻炼。结果患者手术时间为(75.0±21.7)min,术中失血量为(280±130)mL,术后切口均Ⅰ期愈合。患者均获随访,随访时间12～18个月,平均14.2个月。8例于术后3～6个月出现膝关节腔积液,2例分别于术后1周及6个月因摔倒出现股骨假体周围骨折及聚乙烯假体后脱位,均经对症处理后膝关节功能恢复。KSS评分术后3、6、12个月与术前比较以及术后3个月与术后6、12个月比较,差异均有统计学意义(P<0.05);术后6个月与12个月差异无统计学意义(P>0.05)。疼痛评分术前与术后3、6、12个月以及术后各时间点间差异均有统计学意义(P<0.05)。膝关节活动度术后3个月与术前比较,差异无统计学意义(P>0.05);术后6、12个月与术前比较,差异均有统计学意义(P<0.05);术后6个月与术后12个月比较,差异无统计学意义(P>0.05)。结论采用JOURNEY假体行TKA具有手术操作简便、适应证广的特点,近期临床疗效满意。Objective To evaluate the early clinical results of total knee arthroplasty （TKA） with JOURNEY prosthesis. Methods From September 2006 to May 2007, TKA with JOURNEY prosthesis was used to treat 32 patients in ATOS Clinic, Germany. There were 21 males and 11 femals, aged 40-84 years old （average 65.6 years old）. The locations were left knee in 13 cases and right knee in 19 cases, including 5 cases of traumatic arthritis, 19 cases of osteoarthritis and 8 cases of rheumatoid arthritis. All patients had pain and limited range of motion （ROM） of knee. MRI scanning showed that cartilage and miniscus damaged in all cases. The disease course was 1 to 4 years （average 2.2 years）. The CPM practice started 2 days after operation. Results The operative time was （75.0 ± 21.7） minutes. The blood loss was （280 ± 130） mL. All incision healed by first intention. Thirty-two patients were followed up 12 to 18 months （average 14.2 months）. Hydrarthrosis occurred in 8 cases at 3-6 months postoperatively. Femur paraprosthesis fracture and implant dislocation occurred at 1 week and at 6 months in 2 cases, respectively. There were statistically significant differences in KSS score between preoperation and 3, 6, 12 months after operation （P 〈 0.05）, between 3 months and 6, 12 months after operation （P 〈 0.05）; there was no statistically significant difference in KSS score between 6 months and 12 months after operation （P 〉 0.05）. There were statistically significant differences in pain score between preoperation and 3, 6, 12 months after operation （P 〈 0.05）, and in ROM between 3 months and 6, 12 months after operation （P 〈 0.05）. There was no statistically significant difference in ROM between preoperation and 3 months after operation （P 〉 0.05）. Conclusion Ii is a simple way to TKA with JOURNEY prosthesis, which has a good results in early follow-up period.

关 键 词：全膝关节置换 JOURNEY假体 近期疗效 

分 类 号：R687.3[医药卫生—骨科学]