胫骨内侧关节线改变程度对单髁置换术患者膝关节屈伸功能的影响  

Effect of degree of change in medial tibial joint line on flexion and extension of knee joint in patients with unicompartmental knee arthroplasty

作　　者：杨赞礼 袁跃群 谢剑新 魏燕州 袁敏龙 YANG Zan-li;YUAN Yue-qun;XIE Jian-xin;WEI Yan-zhou;YUAN Min-long(Orthopedic Center,Jieyang Ciyun Hospital,Jieyang,Guangdong 522000,China)

机构地区：[1]揭阳市慈云医院骨科中心,广东522000

出　　处：《中国骨与关节损伤杂志》2020年第2期134-136,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨膝关节单髁置换术后胫骨内侧关节线改变程度对患者膝关节屈伸功能的影响。方法回顾性分析自2014-07—2017-05行单髁置换术治疗的48例原发性膝关节骨性关节炎。测量术前与术后3个月膝关节正位X线片胫骨内侧关节线改变程度;术后3个月记录膝关节屈曲0°、30°、60°、90°、120°时膝关节在内侧应力下小腿外翻的角度以评估胫骨平台内侧间隙,分析胫骨内侧关节线改变程度与膝关节KSKS评分、膝关节屈伸角度及不同屈曲角度应力下小腿外翻角度的相关性。结果胫骨内侧关节线改变程度与膝关节屈曲0°应力下小腿外翻的角度呈正相关(r=0.314,P=0.029),胫骨内侧关节线改变程度与膝关节屈伸改善角度呈负相关(r=-0.49,P<0.001)。胫骨内侧关节线改变<3.6 mm者膝关节屈伸改善角度高于关节线改变≥3.6 mm者,差异有统计学意义(P=0.004)。胫骨内侧关节线改变<3.6 mm者膝关节KSKS评分优于关节线改变≥3.6 mm者,差异有统计学意义(P=0.013)。结论单髁置换术后胫骨内侧关节线改变程度与膝关节屈伸改善程度、膝关节KSKS评分改善程度呈负相关,胫骨内侧关节线改变≥3.6 mm可能导致术后患者膝关节屈伸功能改善不佳。Objective To investigate the effect of the degree of articular tibial joint line change after knee single condyle replacement on knee flexion and extension function.Methods A retrospective analysis of 48 patients with primary knee osteoarthritis who underwent unicompartmental knee arthroplasty from July 2014 to May 2017 was conducted.The degree of change in the medial tibial joint line on the knee X-ray before and 3 months after operation were measured.At 3 months after operation,the knee flexion angles of 0°,30°,60°,90°,and 120°of the knee joint were recorded under the medial stress to evaluate the medial space of the tibial plateau.The correlation between the degree of change in the medial tibial joint line and the knee joint KSKS score,knee flexion and extension angle,and calf eversion angle under different flexion angle stress were analyzed.Results The degree of change in the medial tibial joint line was positively related to the angle of the calf eversion under 0°stress of knee flexion(r=0.314,P=0.029).The degree of change in the medial tibial joint line was negatively related to the improvement of knee flexion and extension(r=-0.49,P<0.001).The angle of improvement of knee flexion and extension of the medial tibial joint line<3.6 mm was higher than that of the joint line≥3.6 mm(P=0.004).The KSKS score of the knee joint with a change in the medial tibial joint line<3.6 mm was better than that with a joint line change≥3.6 mm(P=0.013).Conclusion The degree of change in the medial tibial joint line after single condyle replacement is inversely related to the improvement of knee flexion and extension and the improvement of the KSKS score of the knee joint.Changes in the medial tibial joint line≥3.6 mm may lead to poor improvement of knee flexion and extension function.

关 键 词：原发性膝关节骨性关节炎 膝关节单髁置换术 胫骨内侧 关节线改变程度 膝关节屈伸功能 

分 类 号：R687.42[医药卫生—骨科学]