间隙平衡技术在全膝关节置换术中应用的中期随访研究  

Mid-term follow-up of gap balancing technique in total knee arthroplasty

作　　者：孙振辉[1] 刘军[1] 田峥巍[1] 张宇[1] 王磊[1] 孙云波[1] 

机构地区：[1]天津市人民医院关节外科,天津300121

出　　处：《中国矫形外科杂志》2013年第13期1292-1296,共5页Orthopedic Journal of China

摘　　要：[目的]分析间隙平衡技术在全膝关节置换(total knee arthroplasty,TKA)术中应用的临床效果及注意事项。[方法]回顾分析2004年3月～2006年3月应用间隙平衡(gap balancing,GB)技术的TKA患者45例(49膝),男16例,女29例,手术时年龄52～79岁,平均62.4岁。另取同期采用测量截骨(measured resection,MR)技术的TKA患者70例(76膝)设为对照组。比较分析两组患者的手术情况、影像学、膝关节功能恢复情况。[结果]115例患者均获随访,时间6～8年,平均6.8年。GB组单膝手术时间、胫骨截骨量、股骨截骨量均明显低于MR组,术中股骨假体相对外上髁解剖轴内旋角度GB组大于MR组(P<0.05)。TKA术后两组患者髌骨外倾角度存在显著性差异(P<0.05),GB组明显大于MR组。术后膝关节KSS、VAS评分及并发症发生率两组比较均无显著性差异(P>0.05)。[结论]TKA术中应用GB技术手术时间短,截骨量少,股骨假体相对外上髁解剖轴内旋和髌骨倾斜角度较大,中期随访临床效果和MR技术无明显差异,GB技术应避免内侧软组织过度松解,预防术后屈曲失稳及髌股关节并发症。[ Objective] To evaluate the efficiency and surgical notes of gap balancing （GB） technique used in total knee arthroplasty （TKA） . [ Methods] Forty -five cases （49 knees） underwent TKA with GB technique from March 2004 to March 2006 were retrospectively analyzed, including 16 males and 29 females, average age 62. 4. And another 70 patients （76 knees） were selected as control group, who underwent measured resection （MR） technology at the same period. The data of surgery, imaging and knee function were compared. [ Results] All patients were followed up for 6 -8 years, average 6. 8 years. The one side knee surgery time, tibial and femoral bone resection in the GB group was significantly lower than in the MR group, the fem- oral component internal rotation relative to the anatomical epicondylar axis was greater in the GB group （ P 〈 0. 05） . And the patellar tilt angle of GB group was greater than the MR group. KSS, VAS scores and complication rate of the two groups showed no significant difference （P 〉0. 05） . [ Conclusion] GB technique can obtain the same good knee function compared to MR technique in TKA in the midterm follow - up. GB technique can shorten the surgery time and decrease the bone resection a- mount, while the femoral prosthesis internal rotation and patellar tilt angle were great. Excessive medial soft tissue release should be avoided to prevent flexion instability and patellofemoral complications.

关 键 词：全膝关节置换 间隙平衡 测量截骨 屈曲失稳 

分 类 号：R687.4[医药卫生—骨科学]