胫骨扭转角应用于胫骨假体旋转定位的术后疗效分析  

The analysis of postoperative curative effect of the use of tibial torsion angle in the tibia prosthesis rotational alignment positioning

作　　者：高健[1] 沈志敏[1] 高冲[2] 王国胜[1] 

机构地区：[1]新疆医科大学第六附属医院骨科,乌鲁木齐830002 [2]江苏连云港市第二人民医院骨科,江苏连云港222000

出　　处：《新疆医科大学学报》2014年第4期465-469,共5页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2011211A044)

摘　　要：目的探讨在全膝关节置换术中，应用胫骨扭转角确定胫骨假体旋转对线的术后疗效。方法2011年5月-2012年12月，对64例（72膝）患者行固定平台全膝人工关节置换，其中男性21例（22膝），女性43例（50膝），年龄55～78岁，平均年龄62．43岁。将患者随机分为两组：A组28例（30膝），B组36例（42膝）。分别于术前3天、术后1个月、术后6个月对患者进行膝关节手术患者评分表（KSS及HSS）评分及痛视觉模拟评分法（VAs）评定。术中胫骨假体定位方法：A组采用胫骨结节中内1／3线作为解剖标志；B组患者采用胫骨结节中内1／3及胫骨扭转角联合作为解剖标志，所有测定均为同一医师测定。结果所有患者均得到有效随访，患者术后1个月：HSS评分：A组为（86．1±3．5）分，B组为（84．5±4．3）分；KSS评分：A组为（68．2±5．8）分，B组为（66．4±6．7）分；VAs评分：A组为（3．2±0．7）分，B组为（3．2±O．4）分。术后6个月：HSS评分：A组为（80．0±6．8）分，B组为（80．1±4．2）分；KSS评分：A组为（63．4±4．3）分，B组为（63．5±3．7）分；VAS评分：A组为（3．4±0．5）分，B组为（3．3±0．3）分。A组和B组患者术前3天与术后1个月及6个月时相比评分差异均具有统计学意义（P〈0．05），术后1个月与术后6个月相比差异无统计学意义（P〉0．05）。A组与B组组间HSS、KSS、VAS评分比较：术后1个月与术后6个月评分差异无统计学意义（P〉0．05）。A组与B组患者术后1个月与术前3天相比，A组与B组差异无统计学意义（P〉0．05）。在术后6个月与术后1个月HSS、KSS评分比较差异均有统计学意义（P〈0．05），但VAS评分差异无统计学意义（P〉0．05）。结论胫骨扭转角作为一种新的胫骨假体旋转对线定位是可行的，其长期效果还需进一步探讨。Objective To analyze the postoperative curative effect of the use of tibial torsion angle in the tibia prosthesis rotational alignment positioning. Methods 64 patients （72 knees） were treated by total knee arthroplasty from May 2011 to December 2012. Male： 21 cases （22 knees）, female： 43 cases （50 knees）. Age： 55--78 years, average age 62.43, The patients were split at random into two groups. A group： 28 cases （30 knees）, B group： 36 cases （42 knees）. We evaluated the curative effect by KSS, HSS and pain visual analogue scale （VAS） at time of 3 days before operation, and 3 days, 1 month, 6 months after operation. We used tibial tubercle in 1/3 line as the anatomical landmarks in Group A, and tibial tubercle in 1/3 combined with the angle of tibial torsion as the anatomical landmarks in Group B. All the measurements were done by the same physician. Results All patients were given effective follow-ups. Here are the results： one month after surgery： HSS score： A group was （86.1±3.5）, B group was （84.5±4.3）; KSS score： A group was （68.2±5.8）, B group was （66.4±6.7）; VAS score. A group was （3.2±0.7）, B group was （3.2±0.4）. 6 months after operation： HSS score. A group was （80±6.8）, B group was （80.1±4.2）; KSS score： A group was （63.4±4.3）, B group was （63.5±3.7）; VAS score. A group was （3.4±0.5）; B group was （3.34±0.3）. There was statistical difference （P〉0.05） in between 3 days before and 1 month and 6 months after the operation. There was no statistical difference in scores （P〉0.05） between 6 months after operation and 1 month after operation. Comparison between A group and B group HSS, KSS, VAS score, the score of 1 month and 6 months after operation showed no significant difference （P〉0.05）. In patients with postoperative 1 month over the 3 days before operation to improve the situation, in A group, B group showed no significant difference （P〉0.05）, compared improving of 6 months after o

关 键 词：胫骨扭转角 全膝关节置换术 胫骨假体 旋转对线 

分 类 号：R683[医药卫生—骨科学]