单髁置换与胫骨高位截骨后运动学参数的变化  

Changes in kinematic parameters after unicompartmental knee arthroplasty and high tibial osteotomy

作　　者：刘少华 周观明[2] 陈希聪[2] 肖可明[2] 蔡剑[2] 刘效仿 Liu Shaohua;Zhou Guanming;Chen Xicong;Xiao Keming;Cai Jian;Liu Xiaofang(Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine,Foshan 528000,Guangdong Province,China;Tenth Department of Bone,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》2022年第3期390-396,共7页Chinese Journal of Tissue Engineering Research

基　　金：广东省医学科学技术研究(20161181228306),项目参与者:刘少华。

摘　　要：背景:单髁置换和胫骨高位截骨是治疗膝关节内侧间室骨关节炎的两种有效术式,但目前仍缺乏中长期疗效观察,且未有研究将两种方法治疗后的运动学参数进行分析比较。目的:探讨单髁置换与胫骨高位截骨治疗膝关节内侧间室骨关节炎的临床疗效及运动学参数差异。方法:回顾性收集2016年1月至2017年6月佛山市中医院骨科收治并符合纳入标准的97例膝关节内侧间室骨关节炎患者的临床资料,根据治疗方式不同分为2组,其中单髁置换组49例,胫骨高位截骨组48例。记录比较两组患者治疗前及治疗后1,2,3年膝关节活动度、Lysholm膝关节评分、Tegner膝关节运动评分、胫股角,同时采用Opti-Knee膝关节三维运动分析系统记录治疗前、治疗后1,2,3年膝关节在步态过程中三维六自由度活动范围。结果与结论:(1)两组患者手术切口均Ⅰ期愈合且无内植物相关并发症发生,所有患者均获得随访;(2)两组患者治疗后3年膝关节活动度、Tegner膝关节评分、Lysholm膝关节评分、胫股角、膝关节运动学参数均较治疗前明显改善(P<0.05);然而两组间比较各指标差异均无显著性意义(P>0.05);(3)结果提示,对于膝关节内侧单间室骨性关节炎患者,单髁置换和胫骨高位截骨均能有效改善膝关节功能并矫正畸形,并且能够有效改善运动步态参数,两种治疗方式疗效相当,但远期疗效有待进一步研究。BACKGROUND:Unicompartmental knee arthroplasty and high tibial osteotomy are two effective methods for the treatment of medial compartment osteoarthritis of the knee.However,there is still a lack of medium and long-term efficacy observation,and there is no study to analyze and compare the postoperative kinematic parameters of the two.OBJECTIVE:To investigate the clinical efficacy and kinematic parameters of unicompartmental knee arthroplasty and high tibial osteotomy in the treatment of medial compartment osteoarthritis of the knee.METHODS:Clinical data of 97 patients with osteoarthritis in the medial compartment of the knee who were admitted to the Department of Orthopedics,Foshan Hospital of Traditional Chinese Medicine from January 2016 to June 2017 and met the inclusion criteria were retrospectively collected.According to different surgical methods,they were divided into two groups,including 49 cases in unicompartmental knee arthroplasty group and 48 cases in high tibial osteotomy group.The range of motion,Lysholm knee score,Tegner knee motion score and tibiofemoral angle of the two groups were recorded and compared before operation and 1,2,3 years after operation.Simultaneously,Opti-Knee three-dimensional motion analysis system was used to record the threedimensional six degree of freedom range of motion of knee joint during gait before and 1,2,3 years after operation.RESULTS AND CONCLUSION:(1)Both groups of patients healed by first intention and had no complications related to endophytes.All patients were followed up.(2)The range of motion,Tegner knee score,Lysholm knee score,tibiofemoral angle and knee kinematics parameters of the two groups were significantly improved 3 years after operation(P<0.05).However,there was no significant difference in above indexes between the two groups(P>0.05).(3)It is suggested that both unicompartmental knee arthroplasty and high tibial osteotomy can effectively improve knee joint function and correct deformity,and can effectively improve gait parameters for patients with me

关 键 词：膝关节 内侧间室 骨关节炎 单髁置换术 胫骨高位截骨术 疗效 运动学参数 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]