人工全踝关节置换术治疗踝关节损伤性骨关节炎患者多中心临床随机对照研究  

A Multicenter Clinical Randomized controlled Trial of Artificial Total Ankle Joint Replacement in the Treatment of Ankle Traumatic Osteoarthritis

作　　者：魏玉玺[1] 勾波 曹洪[1] 邹海兵[1] 张军[1] 

机构地区：[1]湖北省十堰市人民医院骨关节外科,湖北十堰442000

出　　处：《现代生物医学进展》2017年第34期6752-6755,共4页Progress in Modern Biomedicine

基　　金：湖北省自然科学基金项目(2014CDB222)

摘　　要：目的:探讨传统的踝关节融合术与人工全踝关节置换术在治疗踝关节损伤性骨关节炎患者中的临床早期疗效对比研究。方法:采用随机、对照、开放性的多中心临床试验设计。选择踝关节损伤性骨关节炎患者180例,随机分为2组,常规组90例给予传统踝关节融合术,研究组90例给予踝关节置换术,对比两组手术前后AOFAS(美国骨科足踝协会后足评分)、ROM(关节活动度)、SF-36评分、VAS(视觉模拟评分法)及术后并发症等情况。结果:随访术后3个月影像学检查中,两组X线片内踝关节固定位置良好,未出明显移位或松动。研究组SF-36、AOFAS、ROM评分均显著高于常规组,差异有统计学意义(t=5.587,t=9.695,t=8.122,P均<0.05);研究组VAS评分显著低于常规组,差异有统计学意义(t=18.738,P<0.05);研究组术后并发症总发生率6.25%显著低于常规组总发生率13.33%,差异有统计学意义(x^2=4.851,P<0.05)。结论:踝关节损伤性骨关节炎患者行人工全踝关节置换术可有效改善患者踝关节功能,减轻患足疼痛感,从而提高其生活质量,且术后并发症较少。Objective： To compare the clinical efficacy of conventional ankle arthrodesis and artificial total ankle joint replacement in the treatment of ankle traumatic osteoarthritis. Methods： 180 cases of patients with ankle traumatic osteoarthritis were selected and randomly divided into 2 groups via randomized, controlled, open multicenter clinical trial design. 90 cases of the conventional group were treated with conventional ankle arthrodesis, and 90 cases of the study group received ankle replacement, two groups were compared for preoperative and po. Results： In imaging examinationduring 2 years of follow-up, the X-ray images showed that the naked joint fixed position was good without obvious displacement or loosening. The research group＇s SF-36, AOFAS, ROM scores were sharply higher than those of the routine group, the difference had statistical significance （t =5.587, t =9.695, t =8.122, P〈0. 05 ）; the VAS score of the study group was sharply lower than that of routine group, the difference had statistical points （t =18.738, P〈0. 05）; the incidence of postoperative complications in the study group was 6.25%, which was evidently lower than that of the routine group 13.33%, the difference had statistical meaning （x2=4.851, P〈0.05 ）. Conclusion： Artificial total ankle joint replacement can improve ankle function, relieve pain of sicked feet so as to enhance their life qulity as well as lower postoperative complications.

关 键 词：损伤性骨关节炎 踝关节融合 踝关节置换 

分 类 号：R687.4[医药卫生—骨科学]