活动与固定平台单髁置换治疗膝关节内侧单间室骨关节炎的随访  

Mobile bearing and fixed bearing unicompartmental knee arthroplasty for medial knee osteoarthritis

作　　者：刘少华 周观明[1,2] 陈希聪 肖可明[1,2] 蔡剑 曾会粮[1,2] Liu Shaohua;Zhou Guanming;Chen Xicong;Xiao Keming;Cai Jian;Zeng Huiliang(Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Foshan 528000,Guangdong Province,China;Department of Arthrosis,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong Province,China)

机构地区：[1]广州中医药大学附属佛山中医院,广东省佛山市528000 [2]佛山市中医院骨十科,广东省佛山市528000

出　　处：《中国组织工程研究》2020年第36期5785-5792,共8页Chinese Journal of Tissue Engineering Research

基　　金：广东省中医药局科研项目(20192095),项目参与者:刘少华;广东省医学科学技术研究(20161181228306),项目参与者:刘少华。

摘　　要：背景:单髁置换假体主要分为活动平台和固定平台2种类型,由于两种平台假体的设计理念和手术操作方法上的不同,对于两种平台假体的选择还有一定分歧和争议。目的:比较活动与固定平台单髁假体置换治疗膝关节内侧间室骨性关节炎的临床效果。方法:选择2014年2月至2015年2月佛山市中医院收治的单侧膝关节内侧间室骨关节炎患者154例,男54例,女100例,年龄56-81岁,其中100例接受活动平台单髁假体置换治疗(活动平台组),54例接受固定平台单髁假体置换治疗(固定平台组)。记录并发症发生情况。术后随访膝关节目测类比评分、膝关节活动度、膝关节功能与临床KSS评分,复查X射线片(胫股角、髋-膝-踝角度、胫骨后倾角)评估下肢力线矫正情况。研究符合佛山市中医院对研究的相关伦理要求(fsz20130642)。结果与结论:①154例患者术后获得60-72个月的随访;②两组末次随访的膝关节目测类比评分、膝关节活动度、膝关节功能与临床KSS评分均较术前明显改善(P<0.05),两组间比较差异无显著性意义(P>0.05);③两组末次随访的胫股角、髋-膝-踝角度、胫骨后倾角均较术前明显改善(P <0.05),活动平台组胫股角与髋-膝-踝角度的矫正值大于固定平台组(P <0.05),两组间胫骨后倾角矫正值比较差异无显著性意义(P> 0.05);两组间下肢机械轴位置Kennedy和White分布比较差异无显著性意义(P> 0.05);④活动平台组出现1例假体松动,2例衬垫脱位;⑤结果表明,两种平台单髁置换假体治疗膝关节内侧间室骨性关节炎的中期随访临床结果无明显差异,但活动平台单髁假体置换下肢力线矫正角度较固定平台大,对于恢复下肢解剖轴线更有优势;2种单髁假体术后并发症发生率均较低,活动平台单髁置换后中期随访并发症发生率高于固定平台,活动平台中期并发症主要是假体松动、衬垫脱位。BACKGROUND:Unicompartmental knee arthroplasty prostheses are mainly divided into two different types:mobile bearing and fixed bearing.Due to the different design concepts and surgical methods of the two platform prostheses,there are still some differences and controversies regarding the choice of two different platform prostheses.OBJECTIVE:To compare the clinical effects of mobile bearing and fixed bearing unicompartmental knee arthroplasty in the treatment of medial interventricular osteoarthritis of knee joint.METHODS:From February 2014 to February 2015,154 patients who were diagnosed with osteoarthritis of the medial compartment of the knee joint and underwent unicompartmental knee arthroplasty at the Foshan Hospital of Traditional Chinese Medicine were selected.Among them,there were 54 male and 100 female patients,aged 56-81 years old.Among them,100 patients received unicompartmental knee arthroplasty with mobile bearing(mobile bearing group)and 54 patients received unicompartmental knee arthroplasty with fixed bearing(fixed bearing group).The complications were recorded.After the operation,the visual analogue scale score,knee motion range,knee function and clinical KSS score were followed up.The X-ray films(tibiofemoral angle,hip knee ankle angle,tibial posterior angle)were reexamined to evaluate the force line correction of the lower limbs.The research meets the ethical requirements of Foshan Hospital of Traditional Chinese Medicine(fsz20130642).RESULTS AND CONCLUSION:(1)154 patients were followed up for 60-72 months postoperatively.(2)The visual analogue scale score,knee motion range,knee function and clinical KSS score in the last follow-up of the two groups were significantly improved(P<0.05),and there was no significant difference between the two groups(P>0.05).(3)The tibiofemoral angle,hip knee ankle angle and tibial caster angle in the last follow-up of the two groups were significantly improved(P<0.05).The corrected values of tibiofemoral angle and hip knee ankle angle in the mobile bearing group wer

关 键 词：骨 假体 膝 固定平台 活动平台 单髁置换 关节炎 

分 类 号：R459.9[医药卫生—治疗学] R684.3[医药卫生—临床医学]