胫骨平台缩容技术联合内侧软组织有限松解在全膝关节置换术中的应用  

Application of tibial plateau reduction combined with limited medial soft tissue release in total knee arthroplasty

作　　者：刁乃成[1] 戴益科 喻飞[1] 杨波[1] 张京新 马立峰[1] 李智尧 尹合勇 郭艾[1] DIAO Naicheng;DAI Yike;YU Fei;YANG Bo;ZHANG Jingxin;MA Lifeng;LI Zhiyao;YIN Heyong;GUO Ai(Department of Orthopaedics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《中华骨与关节外科杂志》2023年第3期226-231,共6页Chinese Journal of Bone and Joint Surgery

基　　金：首都医科大学附属北京友谊医院科研启动基金(yyqdkt 2020-16)。

摘　　要：目的:探讨胫骨平台缩容技术联合内侧软组织有限松解在全膝关节置换术(TKA)中纠正内翻畸形的有效性。方法:回顾性分析2017年1月至2020年6月收治的51例TKA病例资料。统计所有病例胫骨平台内侧缩小范围、手术前后内翻度数、美国膝关节协会评分(KSS)、膝关节活动范围(ROM),并对胫骨平台内侧缩小范围与内翻畸形矫正程度的相关性进行分析,同时关注术后胫骨假体下沉及松动情况。结果:所有患者平均随访(34.9±9.2)个月,术前平均内翻角度为(15.6±3.1)°,术前平均ROM为(99.7±10.9)°,术后末次随访时平均内翻角度为(0.9±0.7)°,胫骨平台内侧缩小范围平均为(10.9±1.8)mm,术后末次随访时平均ROM为(130.3±4.6)°。所有患者术后末次随访时KSS功能、KSS临床评分及ROM均高于术前,且差异均有统计学意义(P<0.001),胫骨平台内侧缩小范围与内翻畸形矫正度数有较强的相关性(r=0.73,P<0.001)。所有患者末次随访时均无胫骨假体下沉及松动情况。结论:胫骨平台缩容技术联合内侧副韧带有限松解在TKA中能够有效纠正中重度膝内翻畸形,并且获得良好的术后功能。Objective:To investigate the effectiveness of medial soft tissue limited release combined with tibial plateau reduction in correcting genu varum during total knee arthroplasty(TKA).Methods:A total of 51 patients undergoing TKA between January 2017 and June 2020 were retrospectively analyzed.The reduction of the medial tibial plateau,the degree of varus before and after surgery,KSS scores,and range of motion(ROM)were analyzed.Pearson correlation analysis was performed to analyze the correction between the reduction of the medial tibial plateau and the degree of genu varum.And the subsidence and loosening of the tibial prosthesis were assessed.Results:All the patients were followed up for an average of(34.9±9.2)months.Before surgery,the mean varus angle was(15.6±3.1)°and ROM was(99.7±10.9)°.At the last follow-up,the mean varus angle was(0.9±0.7)°,ROM was(130.3±4.6)°and the reduction of medial tibial plateau was(10.9±1.8)mm.The KSS function score,KSS clinical score and ROM at the last follow-up were significantly higher than those before operation(P<0.001).The reduction of medial tibial plateau was closely correlated with the degree of genu varum(r=0.73,P<0.001).There was no tibial prosthesis subsidence or loosening in any patients.Conclusions:Limited release of medial soft tissue combined with tibial plateau reduction can effectively correct genu varum in TKA and achieve good postoperative function.

关 键 词：全膝关节置换术 膝内翻 软组织松解 胫骨平台缩容 

分 类 号：R684.3[医药卫生—骨科学]