单半径假体全膝关节置换术对重度膝关节骨性关节炎患者膝关节活动度和术后并发症的影响  

Effect of total knee arthroplasty with single radius prosthesis on knee range of motion and postoperative complications in patients with severe knee osteoarthritis

作　　者：任敬 巩航辉 郑世成 王敏 齐亮 路玉峰 贾斌 REN Jing;GONG Hanghui;ZHENG Shicheng;WANG Min;QI Liang;LU Yufeng;JIA Bin(Department of Orthopedics Combined with Traditional Chinese and Western Medicine,Honghui Hospital,School of Medicine,Xi’an Jiaotong University,Xi’an 710054,China;不详)

机构地区：[1]西安交通大学医学部附属红会医院中西医结合骨科,陕西西安710054 [2]延安大学医学院,陕西延安716000

出　　处：《陕西医学杂志》2022年第10期1249-1252,共4页Shaanxi Medical Journal

基　　金：陕西省重点研发计划项目(2018SF-201)。

摘　　要：目的:探讨单半径假体全膝关节置换术(TKA)对重度膝关节骨性关节炎(KOA)患者膝关节活动度和术后并发症的影响。方法:回顾性分析433例重度KOA患者临床资料,按照手术使用假体不同将患者分为行多半径假体TKA术的对照组(n=221例)与行单半径假体TKA术的研究组(n=212例)。观察两组术后并发症发生情况,并比较两组术前、术后3个月膝关节功能(HSS评分)、膝关节活动度(ROM)、膝关节疼痛评分(VAS)、生存质量评分(WHOQOL-100)、炎性指标[白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)]。结果:研究组术后3个月HSS评分、ROM比对照组高(均P<0.05);研究组术前、术后3个月HSS评分、ROM差值比对照组大(均P<0.05);研究组术后3个月VAS评分比对照组低,WHOQOL-100评分比对照组高(P<0.05);研究组术前、术后3个月VAS评分、WHOQOL-100评分差值比对照组大(均P<0.05);研究组术前、术后3个月IL-1β、TNF-α差值均比对照组大(P<0.05);两组术后并发症发生率对比无统计学差异(P>0.05)。结论:相比多半径假体全膝关节置换术,重度膝关节骨性关节炎患者进行单半径假体全膝关节置换术治疗可以明显改善患者膝关节活动度,减轻膝关节疼痛,且不会增加术后并发症发生风险。Objective:To investigate the effect of total knee arthroplasty(TKA) with single radius prosthesis on knee range of motion and postoperative complications in patients with severe knee osteoarthritis(KOA).Methods:The clinical data of 433 patients with severe KOA were retrospectively analyzed.Patients enrolled were divided into control group(221 cases,TKA with multi-radius prosthesis) and study group(212 cases,TKA with single-radius prosthesis) according to the prosthesis applied in TKA.Postoperative complications in the two groups were observed.Knee function(HSS score),knee range of motion(ROM),knee pain(VAS score),quality of life(WHOQOL-100 score),and inflammatory indicators [interleukin 1β(IL-1β),tumor necrosis factor-α(TNF-α)]were compared between the two groups.Results:The study group had higher HSS score and larger ROM than those in the control group at 3 months after operation(all P<0.05).The difference values of HSS score and ROM in the study group before operation and 3 months after operation were larger than those in the control group(all P<0.05).The study group had lower VAS score and higher WHOQOL-100 score than those in the control group at 3 months after operation(all P<0.05).The difference values of VAS score and WHOQOL-100 score in the study group before operation and 3 months after operation were higher than those in the control group(all P<0.05).The difference values of IL-1β and TNF-α in the study group were also higher than those in the control group(all P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Compared with TKA with multi radius prosthesis,TKA with single radius prosthesis can significantly improve knee ROM and alleviate knee pain in patients with severe KOA,without increasing the risk of postoperative complications.

关 键 词：膝关节骨性关节炎 全膝关节置换术 单半径假体 膝关节功能 膝关节活动度 并发症 

分 类 号：R684.3[医药卫生—骨科学]