全膝关节置换术后感染翻修中应用腓肠肌内侧肌瓣转位  

Medial gastrocnemius flap transposition in revision surgery due to infection following total knee arthroplasty

作　　者：贺敬龙 尚宏喜[1] 郝敏[1] 谢伟[1] 孙炜[1] 刘安庆[1] He Jinglong;Shang Hongxi;Hao Min;Xie Wei;Sun Wei;Liu Anqing(Department of Joint Surgery, the Second People’s Hospital of Shenzhen(the First Affiliated Hospital of Shenzhen University), Shenzhen 518037,China)

机构地区：[1]深圳市第二人民医院骨关节科,518000

出　　处：《中华关节外科杂志（电子版）》2021年第3期355-358,共4页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：2020年度深圳市第二人民医院院级临床研究项目(20203357022)。

摘　　要：目的探讨腓肠肌内侧肌瓣转位(MGFT)在全膝关节置换术(TKA)后感染翻修中的疗效。方法选取2014年1月至2020年5月在深圳市第二人民医院骨关节科收治的TKA术后感染翻修手术并行MGFT的病例8例(8膝),对其手术情况、术后并发症及功能恢复情况进行分析。正态分布数据采用配对样本t检验。结果所有8例患者植皮均成活良好,膝关节感染均获得治愈,术后无相关并发症。所有患者经过平均(28±16)个月随访,患者膝关节活动度(ROM)由术前的(40.6±17.8)°提高到术后的(114.4±12.7)°,膝关节学会评分系统(KSS)功能评分由(38.0±8.2)分提高到(85.9±5.7)分,CRP由(32.9±7.1)mg/L降低到(4.0±1.5)mg/L,ESR由(75.23±22.1)mm/h降低到(7.3±3.1)mm/h,差异有统计学意义(t=-17.134、-22.529、12.802、8.305,均为P<0.001)。结论MGFT在TKA术后感染翻修中的应用可填补软组织缺损,是治疗TKA术后感染翻修性软组织缺损的有效方法。Objective To evaluate the surgical efficacy of medial gastrocnemius flap transposition(MGFT)in revision surgery due to infection following total knee arthroplasty(TKA).Methods Eight cases(eight knees)were selected who underwent MGFT in revision surgery due to infection after TKA in the department of joint surgery of the Second People′s Hospital of Shenzhen from January 2014 to May 2020.Their operations,postoperative complications as well as functional recovery were analyzed.Paired-sample t test was used for normal distribution data.Results All eight patients had successful skin grafts and all knee joint infections were cured.No complication was found after the operation.After follow up of(28±16)months in average,the range of motion(ROM)of knee increased from(40.6±17.8)°before the operation to(114.4±12.7)°after the operation,the score of Keen Society Score(KSS)increased from(38.0±8.2)points to(85.9±5.7)points,CRP decreased from(32.9±7.1)mg/L to(4.0±1.5)mg/L,ESR decreased from(75.23±22.1)mm/h to(7.3±3.1)mm/h after the operation.All the differences were statistically significant(t=-17.134,-22.529,12.802,8.305;all P<0.001).Conclusion The application of MGFT in infection revision surgery after TKA can fill the soft tissue defects.

关 键 词：肌皮瓣 关节成形术 置换 膝 感染 翻修 

分 类 号：R68[医药卫生—骨科学]