全膝关节置换术治疗膝关节骨性关节炎的临床观察  

Observation of total knee arthroplasty in treatment of knee osteoarthritis

作　　者：郝瑞胡 郭林[1] 李丽丽[1] 康凯[1] 刘朋飞[1] 陈浩[1] 刘传成[1] 

机构地区：[1]大连大学附属中山医院骨二科,辽宁省大连市116001

出　　处：《中国骨与关节损伤杂志》2014年第6期544-546,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的观察全膝关节置换术（TKA）治疗膝关节骨性关节炎的临床疗效。方法自2012-01—2012-12对50例（59膝）膝关节骨性关节炎行TKA。采用HSS评分标准对手术前后膝关节功能进行评估,并观察有无并发症发生。术后于下肢全长正位X线片上测量机械轴内侧角和股骨假体角（FFC angle）及胫骨假体角（FTC angle）,在侧位X线片上测量股骨假体角（LFC angle）和胫骨假体角（LTC angle）。结果 50例（59膝）均得到平均9（6~12）个月随访。患膝疼痛得到明显缓解或者消失,畸形获得矫正,活动明显改善。末次随访时HSS评分平均（83.66±7.78）分,较术前明显提高。术后X线片均显示假体的位置良好。术后在站立位下肢全长正位X线片上测量机械轴内侧角176°~185°,平均（178±3）°。FFC angle 85°~94°,平均（87±3）°;FTC angle 87°~96°,平均为（90±3）°。LFC angle 78°~89°,平均（85±4）°;LTC angle 77°~95°,平均（87±2）°。结论 TKA可以有效治疗膝关节骨性关节炎,精确测量下肢的力线、恢复膝关节正常的外翻角、注意周围的韧带和软组织的松解平衡是手术的关键。Objective To observe the operative treatment and clinical curative effect of total knee arthroplasty on knee joint osteoarthritis. Methods Fifty patients with knee osteoarthritis of 59 knees between January 2012 and December 2012, from zhongshan hospital affiliated to Dalian university underwent total knee arthroplasty. The knee function before and after operation were evaluated by HSS scoring criteria, and the presence of complications was performed. Medial angle of mechanical axis of leg, frontal femoral component（FFC） angle and frontal tibial component（FTC） angle were measured on a standing long-leg radiograph, meanwhile lateral femoral component（LFC） angle on lateral and lateral tibial component（LTC）angle were measured on the lateral radiograph of knee joint. Results Follow-up visit of 50 cases of 59 knees was an average of 9（6-12） months. Knee pain was significantly reduced or disappeared, deformity of knee was corrected, activity of knee was obviously improved, the last follow-up HSS scoring average was（83.66 ±7.78）points, after operation they were obviously improved. The location of the prosthesis were well shown on postoperative X ray radiograph. After surgery medial angle of mechanical axis of leg was 176°-185°, the average（178±3）°, FFC angle 85°-94°, the average（87±3）°, the FTC angle 87°-96°, the average（90±3）° on a standing long-leg radiograph. LFC angle was 78°-89°, the average（85±4）°, LTC angle 77°-95°, the average（87 ±2）° on a lateral X ray radiograph. Conclusion TKA can effectively treat knee joint osteoarthritis.Precise measurement lines of force of lower limbs, recovering normal valgus angle of knee, paying attention to the ligaments and soft tissue release around the balance are the key to the operation.

关 键 词：全膝关节置换术 膝关节骨性关节炎 机械轴内侧角 股骨假体角 胫骨假体角 

分 类 号：R687.4[医药卫生—骨科学]