全膝关节置换术中测量截骨与间隙平衡技术对股骨外旋截骨参数及膝关节功能的影响  

Effect of measuring osteotomy and gap balance technique on femoral osteotomy parameters and knee joint function in total knee arthroplasty

作　　者：林奇益 林智军 李玉茂[1] 谢晓勇[1] LIN Qi-yi;LIN Zhi-jun;LI Yu-mao;XIE Xiao-yong(Department of Orthopaedics,No.900 Hospital of the Joint Logistics Team of PLA,Putian,Fujian 351100,China)

机构地区：[1]中国人民解放军联勤保障部队第900医院莆田医疗区骨科,351100

出　　处：《中国骨与关节损伤杂志》2021年第6期571-575,共5页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨全膝关节置换术中股骨外旋截骨时测量截骨技术与间隙平衡技术对截骨参数及膝关节功能的影响。方法纳入自2014-01—2016-12行全膝关节置换术治疗的64例膝关节骨性关节炎,34例术中采用间隙平衡技术进行股骨截骨(间隙平衡组),30例术中进行股骨测量截骨(测量截骨组)。比较2组手术时间、截骨参数(股骨假体旋转角、截骨板相对后髁线旋转角、膝关节内翻角、股骨后内髁截骨量、股骨后外髁截骨量),以及术后膝关节功能KSS评分、WOMAC评分、疼痛VAS评分。结果64例均获得随访,随访时间36~60(40.8±4.7)个月。与测量截骨组比较,间隙平衡组手术时间较短,股骨后内髁截骨量更大,股骨假体旋转角更小,截骨板相对后髁线旋转角更大,术后1个月膝关节功能KSS评分更高,差异有统计学意义(P<0.05)。间隙平衡组与测量截骨组术后6个月、1年、3年膝关节功能KSS评分差异无统计学意义(P>0.05)。间隙平衡组与测量截骨组膝关节内翻角、股骨后外髁截骨量、术后MOMAC评分及疼痛VAS评分差异无统计学意义(P>0.05)。结论全膝关节置换术中股骨外旋截骨时采用间隙平衡技术的截骨量比测量截骨技术的截骨量更大,但手术时间缩短,术后短期内膝关节功能恢复效果更好。Objective To investigate the effects of measuring osteotomy technique and gap balance technique on osteotomy parameters and knee joint function during external femoral derotation osteotomy in total knee arthroplasty.MethodsSixty-four patients with knee osteoarthritis treated by total knee arthroplasty from January 2014 to December 2016 were enrolled,34 cases underwent femoral osteotomy by gap balancing technique intraoperatively(gap balancing group)and 30 cases underwent femoral measuring osteotomy intraoperatively(measuring osteotomy group).The 2 groups were compared with respect to operative time,osteotomy parameters(femoral component rotation angle,posterior condyle line rotation angle relative to osteotomy plate,knee varus angle,posterior internal femoral condyle osteotomy,and posterior external femoral condyle osteotomy),and postoperative knee function KSS score,WOMAC score,and pain VAS score.ResultsFollow up was available for all 64 cases and ranged from 36 to 60(40.8±4.7)months.Compared with the measuring osteotomy group,the gap balancing group had a shorter operation time,greater posterior internal femoral condyle osteotomy volume,smaller femoral prosthesis rotation angle,greater posterior condyle line rotation angle of the osteotomy plate,and higher knee function KSS scores at 1 month postoperatively(P<0.05).There was no significant difference in the KSS scores of knee function between the gap balancing group and the measuring osteotomy group at 6 months,1 year,or 3 years after surgery(P>0.05).There were no significant differences between the gap balancing group and the measuring osteotomy group in measuring the knee varus angle,the amount of osteotomy on the posterior femoral condyle,the postoperative Momac score,and the pain VAS score(P>0.05).ConclusionIn total knee arthroplasty,the osteotomies performed with external rotation of the femur using the gap balance technique have a larger amount of osteotomy than those performed with the measuring osteotomy technique,but the operation time is reduced and

关 键 词：膝关节骨性关节炎 全膝关节置换术 股骨外旋截骨 间隙平衡技术 测量截骨 

分 类 号：R687.42[医药卫生—骨科学]