UC旋转平台假体置换治疗膝关节骨关节炎的疗效观察  

EFFECTIVENESS OF UC ULTRA-CONGRUENT ROTATING PLATFORM PROSTHESIS IN TREATMENT OF KNEE OSTEOARTHRITIS

作　　者：霍少川[1] 王海彬[2] 周驰[2] 陈群群[3] 董路珏[4] 唐宏宇[2] 郭承[4] 陈建发[2] 刘勇[4] 

机构地区：[1]广州中医药大学第三临床医学院,广州510405 [2]广州中医药大学第一附属医院关节科 [3]广州中医药大学附属骨伤科医院关节科 [4]广州中医药大学第一临床学院

出　　处：《中国修复重建外科杂志》2015年第11期1342-1347,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的 通过与固定平台假体比较,探讨采用UC旋转平台假体行人工全膝关节置换（total knee arthroplasty,TKA）治疗膝关节骨关节炎的疗效。方法 回顾分析2011年1月-2012年12月因膝关节骨关节炎行TKA的98例（98膝）患者临床资料,其中56例采用UC高型合度型旋转平台假体（旋转平台组）,42例采用Gemini PS后稳定型固定平台假体（固定平台组）。两组患者性别、年龄、患膝关节侧别、体质量、病程、骨关节炎分级、内外翻畸形例数及术前膝关节活动度、膝关节学会评分系统（KSS）评分、疼痛视觉模拟评分（VAS）、股胫角、胫骨角、膝关节面夹角比较,差异均无统计学意义（P〉0.05）,具有可比性。比较两组手术时间（包括麻醉时间）、术中失血量、住院时间、住院费用以及术后膝关节活动度、KSS评分及VAS评分。摄膝关节正侧位X线片,测量股胫角、胫骨角、膝关节面夹角,观察假体有无松动。结果 两组手术时间、术中失血量及住院时间比较,差异均无统计学意义（P〉0.05）;但固定平台组住院费用显著低于旋转平台组（t=8.506,P=0.000）。两组患者均获随访,旋转平台组随访时间为16-30个月,固定平台组为16-38个月。术后固定平台组3例（7.14%）发生并发症,包括切口脂肪液化、关节僵硬、膝前区疼痛各1例;旋转平台组3例（5.36%）发生并发症,包括切口延迟愈合1例、膝前区疼痛2例;两组并发症发生率比较差异无统计学意义（χ2=0.133,P=0.516）。末次随访时,两组KSS评分、VAS评分、膝关节活动度以及股胫角、胫骨角、膝关节面夹角均显著优于术前（P〈0.05）,但两组间比较差异均无统计学意义（P〉0.05）。X线片复查示,两组无透亮线及衬垫脱位征象,未发现髌骨脱位、假体松动及骨折。结论 采用UC旋转平台假体行TKA治疗膝关节骨关节炎,膝关节功能获得有效改善,疼痛缓解明显,疗效与Objective To explore the effectiveness of UC ultra-congruent rotating platform prosthesis in the treatment of knee osteoarthritis by comparing with fixed-bearing implant. Methods The clinical data were retrospectively analyzed, from 98 patients（98 knees） with knee osteoarthritis undergoing primary total knee arthroplasty between January 2011 and December 2012. The UC ultra-congruent rotating platform prosthesis was used in 56 cases（mobile-bearing group） and fixed-bearing implant was used in 42 cases（fixed-bearing group）. There was no significant difference in gender, age, side, weight, disease duration, grading of arthritis, the number of varus and valgus malformation, preoperative range of motion of the knee, the Knee Society Score（KSS） score, the visual analogue scale（VAS） score, femorotibial angle, tibial angle, and articular surface angle between 2 groups（P〈0.05）. The operation time（including anesthetic time）, intraoperative blood loss, hospitalization time, total hospitalization expenses, postoperative range of motion of the knee, the KSS score, and the VAS score were compared. The femorotibial angle, tibial angle, and articular surface angle were measured on the basis of anteroposterior and lateral X-ray films, and prosthesis loosening was observed. Results There was no significant difference in the operation time, intraoperative blood loss, and hospitalization time between 2 groups（P〈0.05）, while the total hospitalization expenses of fixed-bearing group were significantly lower than those of the mobile-bearing group（t=8.506, P=0.000）. The patients were followed up 16-30 months in the mobile-bearing group, and for 16-38 months in the fixed-bearing group. Postoperative complications occurred in 3 cases（7.14%） of the fixed-bearing group（1 case of fat liquefaction of incision, 1 case of joint stiff, and 1 case of anterior knee pain）, and in 3 cases（5.36%） of the mobile-bearing group（1 case of delayed wound healing, and 2 cases of anterior knee pain）; ther

关 键 词：骨关节炎 人工全膝关节置换术 膝关节假体 固定平台 旋转平台 

分 类 号：R687.4[医药卫生—骨科学]