髌骨侧方移位微创全膝关节置换术临床研究  

Comparison of the clinical effect of patella reversal and lateral displacement on total knee arthroplasty

作　　者：唐慧斌[1] 翁伟[1] 李恒[1] 杨红航[1] 孙振国 TANG Huibin;WENG Wei;LI Heng(The First People's Hospital of Huzhou,Zhejiang 313000,China)

机构地区：[1]浙江省湖州市第一人民医院,浙北骨质疏松骨病防治中心,湖州313000

出　　处：《浙江创伤外科》2021年第5期810-812,815,共4页Zhejiang Journal of Traumatic Surgery

基　　金：浙江省基础公益研究计划(LGF20H060009)。

摘　　要：目的探讨术中应用髌骨侧方移位术行微创全膝关节置换术的临床疗效。方法选取2016年12月至2018年12月收治的172例接受单侧全膝关节置换术的患者,根据手术方式分为研究组(术中应用髌骨侧方移位术)与对照组(术中应用髌骨翻转术)。分析两组患者手术时间,切口长度,出血量,术后主动直腿抬高(SLR)时间;Insall-Salvati指数;膝关节活动范围(ROM),膝痛视觉模拟评分(VAS)、美国特种外科医院(HSS)膝关节评分,并进行随访观察。结果全部病例均获得有效随访13~25个月,平均15.8个月。两组患者术后主动直腿抬高(SLR)时间分别为(2.16±0.38,2.44±0.49),研究组优于对照组且差异具有统计学意义(P=0.028);两组患者术后6月膝关节活动范围(ROM)分别为(110.79±5.26,107.50±5.12),研究组优于对照组且差异具有统计学意义(P=0.033)。研究组患者术后2周、1月、6月、12个月美国特种外科医院(HSS)膝关节评分均优于对照组且差异具有统计学意义(P<0.05)。结论全膝关节置换术中应用髌骨侧方移位,患者术后股四头肌肌力恢复更快,膝关节活动范围及功能评分更好。Objective To explore the clinical effect of minimally invasive total knee arthroplasty with lateral displacement of patella.Methods From December 2016 to December 2018,172 patients who underwent unilateral total knee arthroplasty in our hospital were included according to the surgical treatment.They were divided into study group(lateral displacement of patella during operation)and control group(reversal of patella during operation).The operation time,incision length,bleeding volume,active straight leg raising(SLR)time,InsallSalvati index,ROM,VAS and HSS were analyzed and followed up.Results All cases were followed up for 13~25 months,with an average of 15.8 months.The time of active straight leg raising(SLR)in the two groups was(2.16±0.38,2.44±0.49)respectively,and the difference between the two groups was statistically significant(P=0.028).The ROM of knee joint in the two groups was(110.79±5.26107.50±5.12)6 months after operation,and the difference between the two groups was statistically significant(P=0.033).2 weeks,1 month,6 months and 12 months after operation,the score of the knee joint of the study group was better than that of the control group(P<0.05).Conclusion In total knee arthroplasty,the quadriceps femoris muscle strength recovery is faster and the range of motion and function score of knee joint is better in patients with lateral displacement of patella.

关 键 词：全膝关节置换 髌骨侧方移位 髌骨翻转 微创 

分 类 号：R687.3[医药卫生—骨科学]