全膝关节置换术中后交叉韧带保留与切除与否的对比研究  

Comparing posterior cruciate-retaining and posterior cruciate-excising total knee arthroplasty

作　　者：王林[1] 宋磊[1] 韩伟峰[1] 

机构地区：[1]首都医科大学附属北京天坛医院骨科,北京100050

出　　处：《首都医科大学学报》2017年第6期915-918,共4页Journal of Capital Medical University

摘　　要：目的比较全膝关节置换术中,对后交叉韧带采取保留与切除两种处理方式的临床疗效。方法回顾性分析2007至2014年度,首都医科大学附属北京天坛医院膝关节骨性关节病患者56例,其中男性21例,女性35例;左侧20例,右侧36例;年龄52~78岁,平均年龄(66.56±10.33)岁,病程6~15年。术中保留后交叉韧带者34人;术中行后交叉韧带切除者22人。比较二者的手术时间、术中出血、膝关节评分及关节活动度等指标。结果 56例患者经12~36个月随访,平均(25.6±7.3)个月。后交叉韧带保留组和后交叉韧带切除组,手术时间分别为(103±21)min、(98±23)min(P>0.05);术中出血分别为(361±120)mL、(355±98)mL(P>0.05);膝关节评分分别为90.2与88.6分(P>0.05);关节活动度分别为伸:-1.0与-2.5(P<0.05),屈:111与112(P>0.05)。两组手术时间、术中出血、膝关节评分及关节总活动度等差异无统计学意义,但伸展位活动度差异有统计学意义。结论全膝关节置换术中后交叉韧带的保留与否对手术效果影响不大,应依据术中膝关节具体情况以及术者习惯,选择最合适的手术方式。Objective This study was performed to compare the clinical outcomes between patients with posterior cruciate-retaining（CR） and posterior cruciate-excising（CE） total knee arthroplasty（TKA）.Methods From 2007 to 2014,56 patients（21 males and 35 females;20 left,36 right） with an average age of（66.56±10.33） years（from 52 to 78 years） were enrolled in this study.Patients were randomly divided into two groups,including group 1 of 34 patients subjected to CR TKA,and group 2 of 22 patients subjected to CE TKA.The evaluation parameters included operative time,blood loss,knee score and range of motion of knee.Results Fifty-six patients after an average follow-up of（25.6±7.3） months（from 12 to 36 months）.Operative time was（103±21） min,（98±23） min（P0.05）.Blood loss was（361±120） mL,（355±98） mL（P0.05）.Knee score was 90.2 and 88.6 points（P0.05）.Range of motion of knee was,extension：-1.0 and-2.5（P0.05）,flexion：111 and 112（P0.05）.Although there was no significant difference between operative time,blood loss,knee score and the total range of motion of knee,the difference of extension range of motion of knee between the two groups was statistically significant.Conclusion Cruciate-retaining and cruciate-excising TKA function equally well postoperatively.It should be decided on the specific circumstances and the surgeons＇ habit.

关 键 词：全膝关节置换 后交叉韧带 膝关节骨性关节病 

分 类 号：R68[医药卫生—骨科学]