人工全膝关节置换修复晚期膝关节病变的短期随访  

Total knee arthroplasty for terminal knee disease:short-term follow-up

作　　者：陆斌[1] 王金华[1] 张健[1] 李苏皖[1] 胡旺阳[1] 陈小强[1] 

机构地区：[1]马鞍山市人民医院骨科中心,安徽省马鞍山市243000

出　　处：《中国组织工程研究》2015年第26期4132-4138,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:在最近的数十年,人工全膝关节置换被广泛地应用于晚期膝关节病变,如骨关节炎、类风湿关节炎和创伤性骨关节炎等疾病的治疗。全膝关节置换过程中的截骨方法、软组织平衡以及假体旋转定位一直是争论和探讨的问题。目的:探讨晚期膝关节病变行全膝关节置换的修复效果。方法:采用人工全膝关节置换修复31例(31膝)晚期膝关节病变,其中骨关节炎26例26膝,类风湿关节炎5例5膝。所有病例均伴有不同程度屈曲挛缩畸形,最大屈曲畸形角度均小于25°。分别对患者在置换前和置换后进行膝关节美国特种外科医院评分,所有31膝均使用固定平台后稳定型人工全膝关节假体。结果与结论:置换后无早期感染,无假体脱位并发症发生。置换后关节疼痛症状明显缓解、屈曲和内翻畸形均得到明显改善。置换后X射线片显示假体位置良好,下肢力线良好。所有患者均获随访,随访时间6-12个月。膝关节美国特种外科医院评分置换前为(46.4±5.3)分,置换后6个月为(84.6±10.5)分,优良率为84%。提示人工全膝关节置换修复晚期膝关节病变效果确切,但操作较复杂,技术要求精确。BACKGROUND：In recent decades,total knee arthroplasty is widely used in the treatment of terminal knee joint diseases,such as osteoarthritis,rheumatoid arthritis,traumatic arthritis and other bone diseases.The methods of osteotomy,soft tissue balance and prosthesis rotation positioning have always been debated and discussed in total knee arthroplasty.OBJECTIVE：To explore the repair effect of total knee arthroplasty for terminal knee disease.METHODS：Total knee arthroplasty was performed for treating terminal knee disease in 31 cases（31 knees）,including 26 cases of osteoarthritis（26 knees） and 5 cases of rheumatoid arthritis（5 knees）.All cases accompanied flexion contracture deformity to different degrees.The maximum angle of flexion deformity was 25°.All patients were scored by hospital for special surgery knee score before and after replacement.All 31 knees were treated with fixed platform posterior-stabilized prostheses.RESULTS AND CONCLUSION：No complications,such as early infection and prosthesis dislocation,were found after surgery.Joint pain apparently lessened,flexion and varus deformity obviously improved after replacement.Postoperative X-ray films showed good prosthesis position and low limb alignment.All cases were followed up for 6-12 months.The hospital for special surgery knee score improved significantly from preoperatively 46.4±5.3 to postoperatively 84.6±10.5 after 6 months of follow-up.Excellent and good rate was 84%.Results indicate that total knee arthroplasty for treating terminal knee disease has a good clinical effect.However,the operation is complex and precise technique is required.

关 键 词：植入物 人工假体 全膝关节置换 晚期膝关节病变 关节植入物 短期随访 美国特种外科医院评分 并发症 屈曲畸形 

分 类 号：R318[医药卫生—生物医学工程]