两种不同截骨方式对全膝关节术后患者下肢力线和软骨退变的影响  

Effects of two different osteotomy methods on lower limb alignment and cartilage degeneration in patients after total knee joint surgery

作　　者：吴迪[1] 司丽娜[2] 武丽珠 王建华[1] 罗金伟 常乾坤 吕永明[1] 杨阳[1] WU Di;SI Li′na;WU Lizhu;WANG Jianhua;LUO Jinwei;CHANG Qiankun;LÜ Yongming;YANG Yang(Affiliated Hospital of Chengde Medical College,Chengde 067000,Chna;不详)

机构地区：[1]承德医学院附属医院,河北承德067000 [2]承德医学院,河北承德067000 [3]承德市中心医院,河北承德067000

出　　处：《实用医学杂志》2022年第4期415-420,共6页The Journal of Practical Medicine

基　　金：承德市科学技术研究与发展计划项目(编号:202109A034)。

摘　　要：目的探讨间隙平衡法和测量截骨法两种不同截骨方式对全膝关节置换术(TKA)患者下肢力线和软骨退变的影响。方法选取2019年1月至2021年4月我院97例拟行TKA患者,随机数字表法分为采取间隙平衡法的间隙组(n=49),采取测量截骨法的测量组(n=48)。比较两组围术期指标、下肢力线指标、软骨退变指标、创伤应激指标、视觉模拟评分法(VAS)、美国纽约特种外科医院(HSS)膝关节评分、并发症情况。结果间隙组股骨远端截骨量、聚乙烯衬垫厚度大于测量组(P<0.05);(2)术后3 d两组血清Cor、NE水平均高于术前(P<0.05);(3)术后1、3个月间隙组OPG、PANKL水平低于测量组(P<0.05);(4)术后1、3个月间隙组mMPTA、mLDFA、ROM高于测量组(P<0.05);(5)术后1、3个月间隙组VAS评分低于测量组,HSS评分高于测量组(P<0.05);(6)两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论间隙平衡法在下肢力线、软骨退变、疼痛及膝关节功能恢复方面效果优于测量截骨法,尤适用于TKA患者。Objective To investigate the effect of two different osteotomy methods on lower limb alignment and cartilage degeneration in patients with total knee arthroplasty(TKA).Methods From January 2019 to April 2021,97 patients in our hospital who were scheduled to undergo TKA were selected and randomly divided into a gap group(n=49)and a measurement group(n=48)by random number table.Bone method.Perioperative indicators,lower limb alignment indicators,cartilage degeneration indicators,trauma stress indicators,visual analogue scale(VAS),New York Hospital for Special Surgery(HSS)knee joint score,and complications were counted between the two groups.Results(1)The amount of distal femoral osteotomy and the thickness of the polyethylene cushion in the gap group were greater than those in the measurement group(P<0.05);(2)Serum Cor and NE levels in the two groups were higher than those before surgery on the 3rd day after surgery(P<0.05);(3)The OPG and PANKL levels in the 1 month and 3 months interval group were lower than those in the measurement group(P<0.05);(4)MPTA and LDFA in the 1 month and 3 months interval group were lower than those in the measurement group,and ROM was higher than that in the measurement group(P<0.05);(5)VAS scores in the 1 month and 3 months interval group were lower In the measurement group,the HSS score was higher than that in the measurement group(P<0.05);(6)There was no statistically significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion The gap balance method is better than the measurement osteotomy method in terms of lower limb force line,cartilage degeneration,pain and knee function recovery,and it is especially suitable for patients with TKA.

关 键 词：全膝关节置换术 间隙平衡法 测量截骨法 下肢力线 软骨退变 假体松动 

分 类 号：R683.4[医药卫生—骨科学]