髁限制性膝关节假体置换治疗晚期膝类风湿关节炎的疗效  

The effect of legacy constrained condyar knee in the total knee arthroplasty for advanced knee rheumatoid arthritis

作　　者：范时洋 曾忠友 宋永兴 俞伟 吴宏飞 FAN Shi-yang;ZENG Zhong-you;SONG Yong-xing;YU Wei;WU Hong-fei(SectionⅡ,Dept of Orthopaedics,the Marine Police Corps Hospital of Chinese Armed Police Force,Jiaxing,Zhejiang 314000,China)

机构地区：[1]中国人民武装警察部队海警总队医院骨二科,浙江嘉兴314000

出　　处：《临床骨科杂志》2022年第6期801-804,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨髁限制性膝关节假体(LCCK)置换治疗晚期膝类风湿关节炎(RA)的疗效。方法采用LCCK置换治疗28例晚期膝RA患者。记录手术情况,采用HSS评分评价膝关节功能。结果患者均获得随访,时间2~74个月。手术时间80~120(95.20±3.85)min。术中+术后出血量110~400(260.50±45.35)ml。术后内、外翻应力试验均阴性;X线片显示膝关节力线均明显改善,畸形完全矫正。26例膝关节活动轨迹良好;2例髌股轨迹不佳,有半脱位表现,拇指试验阳性。末次随访时,患者均可独立正常步态行走;膝关节活动度:26例屈曲120°、伸直0°,2例屈曲90°、伸直0°;HSS评分77~90(86.3±1.5)分,明显高于术前的26~48(43.3±2.4)分,差异有统计学意义(t=37.68,P<0.05),其中优22例,良4例,可2例,优良率26/28。结论采用LCCK置换治疗晚期膝RA,关节稳定性较好,患者膝关节功能恢复满意。Objective To investigate the effect of legacy constrained condyar knee(LCCK)in the primary total knee arthroplasty(TKA)for advanced knee rheumatoid arthritis(RA).Methods The 28 patients with advanced knee RA were treated by TKA with LCCK.The operation condition was recorded,and the knee function was evaluated by HSS score.Results All patients were followed up for 2~74 months,the operation time was 80~120(95.20±3.85)min,the intraoperative plus postoperative bleeding volume was 110~400(260.50±45.35)ml.The varus and valgus stress tests were both negative at the postoperation;X-ray films showed that the mechanical axis of the knee joint was significantly improved,and the deformity was completely corrected.The 26 cases had good knee joint trajectories,and other 2 cases with poor patellofemoral trajectories,subluxation and positive thumb test.At the last follow-up,the patients could walk independently with normal gait.Knee joint range of motion:26 cases were flexion with 120°and extension with 0°,2 cases were flexion with 90°and extension 0°.The HSS score was 77~90(86.3±1.5)points,which was significantly higher than the preoperative score of 26~48(43.3±2.4)points,the difference was statistically significant(t=37.68,P<0.05);of which 22 cases were excellent,4 good and 2 fair,the excellent and good rate was 26/28.Conclusions TKA using LCCK is used to treat advanced RA,with good joint stability and satisfactory knee function recovery.

关 键 词：髁限制性膝关节假体 膝类风湿关节炎 严重膝内外翻 

分 类 号：R593.22[医药卫生—内科学] R687.4[医药卫生—临床医学]