股骨髓内定位通道嵌压植骨减少全膝置换术后出血的前瞻性研究  

Effects of bone graft compacted into the femoral positioning tunnel made by intramedullary alignment instrumentation in total knee arthroplasty on postoperative bleeding:a prospective controlled study

作　　者：胡飞[1] 尚希福[1] 朱亚林[1] 纪晓封 张晓琪[1] 

机构地区：[1]安徽医科大学附属安徽省立医院骨科,合肥230001

出　　处：《中国矫形外科杂志》2016年第17期1566-1569,共4页Orthopedic Journal of China

基　　金：安徽高等学校省级科研重点项目(编号:KJ2013A160)资助

摘　　要：[目的]探讨股骨髓内定位通道采用截骨块嵌压植骨减少全膝置换术后出血的临床效果。[方法]采用前瞻性研究方法，对2009年1月～2015年5月在本院接受单侧初次膝关节置换的60例膝关节骨性关节炎患者，随机分成两组，30例术中股骨侧髓腔定位通道用截骨块植入封闭（植骨组），另30例髓腔通道不做处理（对照组）。随访6—68个月，平均32个月。观察指标包括手术时间、术中出血量、术后引流量、手术后并发症，末次随访时采用HSS评分评价患膝功能。[结果]植骨组的术后引流量明显比对照组减少，两组比较差异具有统计学意义。两组患者的手术时间、术中出血量和末次随访时患膝HSS评分差异无统计学意义。对照组有6例患者术后两个月患膝关节内反复出现血性积液。[结论]股骨髓内定位通道采用截骨块嵌压植骨能够有效减少全膝置换术后失血量，并能取得较好的临床效果，值得临床推广应用。[ Objective] To investigate the clinical effects of bone graft compacted into the femoral positioning tunnel made by intramedullary alignment instrumentation in total knee arthroplasty （TKA） on postoperative bleeding. [ Methods ] A prospective controlled study was performed in 60 patients with knee osteoarthritis who underwent unilateral TKA for the first time in our hospital from January 2009 to May 2015. These patients were equally and randomly divided into two groups： control group and bone graft group. The bone graft was compacted into the femoral positioning tunnel made by intramedullary alignment instrumentation for the patients in the bone graft group, but not in the control group. Their mean follow - up was 32 months （6 - 68 months） . The two groups were compared in terms of operation time, intraoperative blood loss, postoperative drainage, postoperative complications, and Hospital for Special Surgery （HSS） knee - rating score for assessing the knee function at the last fol- low - up. [ Results ] The bone graft group had significantly less postoperative drainage than the control group （P 〈 0. 05 ） . But there were no significant differences in operation time, intraoperative blood loss, and HSS score between the two groups （ P 〉 0.05 ） . At 2 months after surgery, recurrent bloody effusion was present in the knee joints of 6 patients in the control group. [ Conclusion ] In TKA, bone graft compacted into the femoral positioning tunnel made by intramedullary alignment instrumentation can effectively reduce postoperative bleeding and achieve a good clinical effect, so it holds promise for clinical application.

关 键 词：关节成形术 置换 膝 手术后出血 前瞻性研究 

分 类 号：R687.4[医药卫生—骨科学]