全膝关节置换治疗膝关节外翻畸形的临床分析  

Clinical analysis of total knee arthroplasty for treatment of valgus knee deformity

作　　者：周卫[1] 徐振伟[1] 马国涛[1] 吴登科[1] 赵世阳[1] 

机构地区：[1]河南省平顶山市第一人民医院关节骨病科,河南平顶山467000

出　　处：《中国现代医生》2016年第12期55-57,61,F0003,共5页China Modern Doctor

摘　　要：目的观察全膝关节置换（TKA）治疗膝关节外翻畸形的临床效果。方法回顾性分析2010年10月～2014年10月采用TKA治疗膝关节外翻畸形患者27例（32膝）的临床资料,其中男6例,6膝关节,女21例,26膝关节,年龄31～72岁,平均68.7岁,进行临床效果评价。结果置换后随访12～48个月,术后切口均一期愈合,无感染,无腓总神经麻痹发生,患者膝关节活动范围术前50°～105°,平均（68.50±17.56）°,术后90°～125°,平均（108.50±26.78）°,股胫角术前11°～31°,平均（18.2±5.1）°,术后3°～11°,平均（8.5±2.1）°,美国特种外科医院膝关节评分（HSS）术前28～54分,平均（39.0±4.57）分,术后45～100分,平均（88.2±15.8）分,两组比较差异有统计学意义（P〈0.05）。结论膝关节外翻畸形可采用常规截骨、单纯外侧软组织松解及后稳定型假体植入,能较好地矫正外翻畸形,近期疗效满意。Objective To observe clinica I effects of tota I knee arthroplasty（TKA） for valgus knee deformity.Methods Clinical data of 27 cases of valgus knee deformity（32 knees） undergoing total knee arthroplasty were retrospectively analyzed from October 2010 to October 2014.There were 6 males（6 knees）and 21 females（26 knees）,at the age from 31 to72 years,with an average age of 68.7 years.Clinical efects of total knee arthroplasty were evaluated.Results The postoperative follow-up lasted from 12 to 48 months.All cuts had healed,no infection,and no peroneal nerve paralysis.Joint range of motion were rectified from preoperatively（68.5±17.6）°（range,50°-105°） to preoperatively（108.5±26.8）°（range,90°-125°） on average.Femorotibial angle were rectified from preoperatively（18.2±5.1）°（range,11°-31°） to postoperatively（8.5±2.1）°（range,3°-11°）.Hospital for Special Surgery knee score（HSS） were rectified from preoperatively 39.0±4.57（range,28-54） 39.0 to postoperatively 88.2±15.8（range,45-100）（P〈0.05）.Conclusion The techniques of standard osteotomy and only lateral soft tissue release with posterior stabilized implants can deal with a valgus knee deformity very successfully in patients undergoing primary total knee arthroplasty,and provide excellent results.

关 键 词：膝关节外翻 全膝关节置换术 外侧软组织松解 HSS评分 

分 类 号：R687[医药卫生—骨科学]