PS与CR全膝关节置换术对单侧膝关节OA患者术后早期功能恢复的影响对比  

Comparison of the Effects of PS and CR Total Knee Arthroplasty on Early Postoperative Functional Recovery of Patients with Unilateral Knee OA

作　　者：张江礼[1] 刘金辉[1] 潘西庆[1] 刘光源 范虓 ZHANG Jiangli;LIU Jinhui;PAN Xiqing;LIU Guangyuan;FAN Xiao(Shijiazhuang Third Hospital,Shijiazhuang 050000,China)

机构地区：[1]石家庄市第三医院,河北石家庄050000

出　　处：《中国医学创新》2023年第11期56-61,共6页Medical Innovation of China

基　　金：石家庄市科学技术研究与发展指导计划项目(181460613)。

摘　　要：目的:分析后稳定型(PS)膝关节假体与后交叉韧带保留型(CR)膝关节假体全膝关节置换术对单侧膝关节骨关节炎(OA)患者术后早期功能恢复的影响。方法:选取石家庄市第三医院2018年12月-2020年5月收治的100例单侧膝关节OA患者,依照随机信封法分为PS组和CR组,各50例。PS组将患者后交叉韧带去除并置入PS膝关节假体,CR组保留患者后交叉韧带并置入CR膝关节假体。记录两组治疗一般情况;记录患者术前、术后1周、术后3、6个月的视觉模拟评分法(VAS)、牛津大学膝关节评分(OKS)、膝关节HSS评分及膝关节活动度;术后6个月采用健康调查简表(SF-36)对患者生活质量进行评估;记录两组术后不良反应发生情况及满意度。结果:两组住院时间、手术时间比较,差异均无统计学意义(P>0.05),PS组术后引流量明显高于CR组(P<0.05)。术前、术后1周,两组内翻角度和最大屈曲比较,差异均无统计学意义(P>0.05);术后3、6个月,PS组内翻角度均小于CR组,最大屈曲均大于CR组(P<0.05)。术前、术后1周,两组VAS评分、OKS、膝关节HSS评分比较,差异均无统计学意义(P>0.05);术后3、6个月,PS组以上评分均优于CR组(P<0.05)。术前、术后6个月两组生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能和精神健康评分比较,差异均无统计学意义(P>0.05)。两组血栓、神经损伤、关节不稳、假体松动发生率及不良反应总发生率比较,差异均无统计学意义(P>0.05)。PS组治疗总满意度明显高于CR组(P<0.05)。结论:相较于CR膝关节假体,PS膝关节假体全膝关节置换术治疗单侧膝关节OA,更有利于患者术后早期功能恢复。Objective:To analyze the effects of total knee arthroplasty with posterior stabilized(PS)knee prostheses and posterior cruciate-retaining(CR)knee prostheses on early postoperative functional recovery of patients with unilateral knee osteoarthritis(OA).Method:A total of 100 patients with unilateral knee OA who were admitted to Shijiazhuang Third Hospital from December 2018 to May 2020 were divided into PS group and CR group according to the random envelope method,50 cases in each group.In the PS group,the posterior cruciate ligament was removed and the PS knee prostheses was inserted,while in the CR group,the posterior cruciate ligament was preserved and the CR knee prostheses was inserted.The general treatment conditions of the two groups were recorded.The visual analogue scale(VAS),Oxford knee score(OKS),knee hospital for special surgery(HSS)score,and knee range of motion were recorded at preoperative and 1 week,3 months,6 months after the operation.The quality of life was assessed at 6 months after the operation using the SF-36.The incidence of adverse reactions and satisfaction were recorded in two groups.Result:There were no significant differences in hospital stay and operation time between the two groups(P>0.05),and the postoperative drainage in the PS group was significantly higher than that in the CR group(P<0.05).There were no significant differences in varus angle and maximum flexion between the two groups before and 1 week after operation(P>0.05).3 and 6 months after operation,the varus angle in the PS group were smaller than those in the CR group,and the maximum flexion were greater than those in the CR group(P<0.05).There were no significant differences in VAS scores,OKS scores and knee HSS scores between the two groups before and 1 week after operation(P>0.05).3 and 6 months after operation,the above scores in the PS group were better than those in the CR group(P<0.05).There were no significant differences in the scores of physiological function,physical function,physical pain,general health,vitalit

关 键 词：膝关节骨关节炎 后稳定型膝关节假体 后交叉韧带保留型膝关节假体 膝关节功能 

分 类 号：R687.4[医药卫生—骨科学]