内轴膝关节系统中胫骨假体后倾角度对术后功能影响  

EFFECT OF THE POSTERIOR SLOP ANGLE OF THE TIBIAL PROSTHESIS IN A MEDIAL-PIVOT KNEE SYSTEM ON POSTOPERATIVE FUNCTION

作　　者：陈冠宏[1] 马金朋 王英振 李洪彪 赵留静 翟喜成[1] CHEN Guanhong;MA Jinpeng;WANG Yingzhen;LI Hongbiao;ZHAO Liujing;ZHAI Xicheng(Department of Orthopedics, Shanxian Central Hospital, Shanxian 274300, China)

机构地区：[1]单县中心医院骨科,山东单县274300 [2]菏泽市立医院骨科

出　　处：《青岛大学学报（医学版）》2019年第2期164-167,共4页Journal of Qingdao University(Medical Sciences)

基　　金：国家自然科学基金项目(81772329)

摘　　要：目的探讨内轴型(MP)膝关节系统中胫骨平台后倾角(PSA)对全膝关节置换术(TKA)后关节功能的影响及其相关因素。方法随访40例老年女性单侧膝骨关节炎终末期行单侧TKA手术病人(术中均采用MicroPort公司MP膝关节2号Advance stature假体),随访时间至少4个月,记录病人术前和术后膝关节活动度(ROM)、膝关节手术评分表(KSS)评分、胫骨平台PSA等指标,分析不同胫骨平台PSA角度病人术后ROM的差异,以及BMI、术前ROM、术前KSS评分对术后功能恢复的影响。结果术前膝关节ROM、术后胫骨平台PSA、术前KSS评分与术后膝关节KSS评分呈正相关(r=0.389～0.825,P<0.05),BMI与术后膝关节KSS评分呈负相关(r=-0.623,P<0.05)。术后胫骨平台PSA为5°～7°病人术后功能恢复最优。结论病人BMI增高不利于TKA后功能恢复,较高的术前ROM和KSS评分有利于术后的功能恢复;术后胫骨平台PSA 5°～7°有可能是MP膝关节系统的最适宜PSA。Objective To investigate the effect of the posterior slope angle (PSA) of the tibial plateau in a medial-pivot (MP) knee system on the knee joint function after total knee arthroplasty (TKA) and its related factors. Methods A follow-up lasting at least 4 months was conducted in 40 elderly female patients who had undergone a TKA (size 2 Advance Stature MP knee prosthesis from MicroPort was used) for end-stage unilateral knee arthritis;the patients were evaluated for preoperative and postoperative knee range of motion (ROM), Knee Society Score (KSS), and PSA of the tibial plateau;analyses were conducted on the difference in the postoperative ROM in patients with different PSAs of the tibial plateaus and the effects of body mass index (BMI), preoperative ROM, and preoperative KSS on postoperative functional recovery. Results The preoperative knee ROM, postoperative PSA of the tibial plateau, and preoperative KSS were positively correlated with the postoperative KSS ( r =0.389- 0.825, P <0.05);BMI was negatively correlated with the postoperative KSS ( r =-0.623, P <0.05). Patients with a postoperative PSA of the tibial plateau of 5°-7° had optimal postoperative functional recovery. Conclusion Increased BMI negatively contri- butes to functional recovery after TKA, while higher preoperative ROM and KSS positively contribute to functional recovery. The best PSA for a MP knee system may be 5°-7°.

关 键 词：关节成形术 置换 膝 MP膝关节系统 胫骨平台后倾角 关节动度测量法 关节 

分 类 号：R687.42[医药卫生—骨科学]