全膝关节置换治疗膝关节外翻畸形9例  

Total hip replacement for 9 patients with valgus knee deformity

作　　者：贾效敏[1] 王君峰[1] 石南征[1] 马东平[1] 

机构地区：[1]山西焦煤集团职工总医院骨科,山西省太原市030053

出　　处：《中国组织工程研究与临床康复》2010年第30期5555-5558,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景：人工膝关节置换能够为严重膝关节病患者解除疼痛、矫正畸形,是改善患者生活质量的有效治疗手段。目的：分析膝关节外翻畸形患者行人工全膝关节置换的手术方法和临床效果。方法：选择9例（9膝）女性膝外翻患者,年龄50-75岁,术前X射线测量膝外翻畸形平均12.9°（10°-37°）。采取髌旁内侧入路,经常规截骨加单纯外侧软组织松解等处理后,进行全膝关节置换。置换后随访检查膝关节活动度,X射线检测膝外翻角度及HSS评分评价手术效果。结果与结论：8例患者获得随访,随访时间48（24-72）个月。膝外翻角度由置换前的12.9°降低到4.3°,膝关节平均活动度由置换前的75°提高到为105°,HSS评分由置换前31.17分提高到87.83分,差异均有非常显著性意义（P〈0.01）。所有患者行全膝关节置换后外翻畸形基本得到矫正,所有病例置换后无明显疼痛,行走、上下楼梯等功能较置换前明显改善。说明对于膝关节外翻畸形者,采用髌旁内侧入路、常规截骨加单纯外侧软组织松解后行全息关节置换早期可取得较满意的临床效果,后期疗效有待进一步随访观察。BACKGROUND：Artificial joint replacement can relieve pain,correct deformity and improve life quality of patients with severe joint disease.OBJECTIVE：To investigate the methods and clinical results of total knee replacement in patients with valgus knee deformity.METHODS：A total of 9 cases（9 knees） of valgus knee,aged 50-75 years,were treated with selected.X-ray before operation showed average 12.9°valgus（ranging from 10°to 37°）.Medial parapatellar approach was adopted,and standard osteotomy and only lateral softtissue release were performed,following by total knee replacement.Clinical and radiographic evaluations including range of motion（ROM） and Knee Society Score System（KSS） were performed during follow-up.RESULTS AND CONCLUSION：The valgus angle was reduced from 12.9°to 4.3°after replacement,and range of motion was improved from 75°to 105°The average HSS scores increased from preoperative 31.17 to postoperative 87.83.All changes were significantly different（P 0.01）.All valgus was corrected basically.All of the cases had no pains after operation,and the function of knees were apparently improved.The techniques of medial parapatellar approach,standard osteotomy and only lateral soft tissue release can correct a fixed valgus deformity successfully in patients undergoing primary total knee replacement,and preliminarily provides excellent results.The follow-up is necessary for further long-term outcome.

关 键 词：关节成形术 置换 膝外翻 畸形 人工假体 

分 类 号：R318[医药卫生—生物医学工程]