滑移截骨术在人工膝关节置换治疗膝外翻畸形中的应用  

Role of sliding osteotomy of lateral femur condyle in correcting severe fixed valgus deformity in total knee arthroplasty

作　　者：周新华[1] 唐竞[1] 吴坚[1] 张纪[1] 周一新[1] 

机构地区：[1]北京积水潭医院矫形科, 100035

出　　处：《中华医学杂志》2014年第25期1963-1965,共3页National Medical Journal of China

摘　　要：目的：探讨滑移截骨术在人工膝关节置换（ TKA）治疗膝关节固定外翻畸形患者的治疗方法。方法对2007年11月至2009年11月北京积水潭医院矫形骨科11例11个膝关节外翻畸形TKA手术进行回顾性分析。患者男2例，女9例，平均年龄67（58～76）岁。采用髌旁内侧入路、常规截骨、软组织松解后行股骨外侧髁滑移截骨，应用后稳定型膝关节假体行全膝关节置换术。术后随访12～61个月，采用膝关节手术患者功能评分表（ KSS）相关指标进行测量和评估。结果膝关节评分由术前为（51.5±7.8）分增加到（89.9±2.8）分；KSS功能评分从术前（40.4±7.3）分增加至（84.2±5.9）分。股胫角由术前（161.4±4.4）°增加到（172.8±1.0）°。随访时没有发现有膝关节不稳及髌骨脱位等并发症。结论对于膝关节有固定外翻畸形患者，采用股骨外侧髁滑移截骨方法进行人工膝关节置换术，可取得比较满意的临床效果。Objective To explore the surgical techniques and clinical efficacy of sliding osteotomy of lateral femur condyle in severe fixed valgus deformity during total knee arthroplasty （ TKA）.Methods A total of 11 consecutive patients （ 11 knees ） undergoing primary TKA for severe valgus deformities were recruited between November 2007 to November 2009.There were 2 males and 9 females with an average age of 67 （58-76） years.The follow-up period was 12-61 months.Primary TKA was performed via a medial parapatellar approach.And conventional osteotomy and soft tissue release were performed.Sliding osteotomy of lateral femur condyle was performed in all cases.Posterior stabilized prosthesis was employed and clinical outcomes were evaluated by the relevant parameters.Results The knee society score improved from 51.5 ± 7.8 to 89.9 ±2.8 and functional score increased from 40.4 ±7.3 to 84.2 ±5.9.The tibiofemoral angle changed from a preoperative value of （161.4 ±4.4）°to a postoperative value of （172.8 ±1.0）°.Patella dislocation was not reported.And no other complications occurred during the follow-up.Conclusion Sliding osteotomy of lateral femur condyle is effective for fixed valgus knee deformity during TKA.Improvement of joint function may be achieved significantly with satisfactory clinical outcomes.

关 键 词：关节成形术 置换 膝 截骨术 勒福 膝外翻 

分 类 号：R687.4[医药卫生—骨科学]