旋转铰链型膝关节假体临床应用30例随访观察  

Clinical result of rotational hinge knee prosthesis in 30 TKAs

作　　者：及松洁[1] 李玉军[1] 黄野[1] 周乙雄[1] 张洪[1] 殷建华[1] 周一新[1] 

机构地区：[1]北京积水潭医院矫形骨科,100035

出　　处：《中国矫形外科杂志》2009年第19期1455-1458,共4页Orthopedic Journal of China

摘　　要：[目的]探讨采用旋转铰链式人工膝关节假体进行全膝关节置换术的早期及中期临床疗效、并发症、假体选择的适应证。[方法]回顾性分析1998年7月～2008年7月10年间使用旋转铰链式膝关节假体行人工全膝关节置换的28例患者(30例膝)临床效果。其中男7例,女21例;平均年龄62岁(42～75岁);左膝10例,右膝20例。病因:膝内翻合并重度骨关节炎8膝,类风湿关节炎2膝,创伤性关节炎3膝,畸形性骨炎1膝,严重膝外翻畸形6膝,全膝关节置换术后假体松动翻修10膝(6例感染后松动,4例无菌性松动)。术前术后使用KSS评分进行评价。[结果]本组病例平均手术时间为3 h10 min(1 h 30 min～6 h30 min),术中平均失血量为990 ml(150～3 000 ml),术中及术后平均输异体血1 300 ml。28例病例平均随访51个月(12～120个月)。膝关节评分从术前的19.5分增加到术后的平均77.9分(28～93分),功能评分从术前的22.5(0～50分)增加到术后的50.5分(0～90分)。膝关节平均活动范围从术前58.4°(0°～90°)提高到术后的72.8°(10°～100°)。1例发生髌腱断裂,1例发生假体断裂,5例发生>10°的伸膝迟滞,8例出现明显的膝前痛。[结论]旋转铰链式膝关节假体作为治疗严重膝关节疾病的方法,可以一定程度恢复膝关节功能,中期随访结果满意,但因其手术损伤大,要严格把握手术适应证,预防并发症的发生。[ Objective] To investigate the indications, complications and mid- term results of total knee arthroplasties u- sing rotating hinge knee prosthesis. [ Methods] Thirty total knee arthroplasties using rotating hinge prosthesis were performed in twenty - eight patients from July 1998 to July 2008. Seven patients were male and twenty - one patients were female. The aver- age agewas 62 years （42 -75 years） . The diagnosis included osteoarthritis in 8 patients, rheumatoid arthritis in 2 patients, traumatic arthritis in 3 patients, Paget＇s disease patient, serious genu valgum in 7 patients and 10 failure TKAs. All patients were followed up for 12 to 120 months. The patients were evaluated according to knee score system and the complications were observed. [ Results ] The pain was relieved and function was improved in all knees. The average knee pain score increased from 19. 5 to 77. 9, and knee function score from 22. 5 to 50. 5. Range of motion of knees increased from 58.4°to 72. 8°. No re- vision was needed in all patients, The complications included anterior knee pain （8 cases） , extension lag （5 cases）, prosthesis broken （ 1 case） and patella tendon rupture （ 1 case） . [ Conclusion] The mid - term results of total knee arthroplasty using rotating hinge knee for severe knee deformity are satisfactory. Complications should be prevented carefully.

关 键 词：关节成形术 全膝人工关节置换 关节假体 疗效评价 

分 类 号：R687.4[医药卫生—骨科学]