探讨对严重膝外翻畸形经髌旁外侧入路行全膝关节置换术治疗的临床效果  

Exploring the Clinical Effect of Total Knee Arthroplasty by Paratellatellar Lateral Approach for Severe Valgus Deformity

作　　者：吕东维 兰爽 宁波 LYU Dongwei;LAN Shuang;NING bo(Department of Joint Surgery,Dongying People's Hospital,Dongying,Shandong Province,257300 China;Department of Gynecology,Dongying People's Hospital,Dongying,Shandong Province,257300 China)

机构地区：[1]东营市人民医院关节外科,山东东营257300 [2]东营市人民医院妇科,山东东营257300

出　　处：《中外医疗》2023年第10期80-84,共5页China & Foreign Medical Treatment

摘　　要：目的分析髌旁外侧入路与髌旁内侧入路在严重膝外翻畸形全膝关节置换术中的应用效果。方法随机选择2017年6月—2021年5月东营市人民医院进行严重膝外翻畸形治疗的患者150例为研究对象,根据患者所实施的手术方式的不同分为参照组(76例)和研究组(74例)。参照组患者行髌旁内侧入路治疗,研究组患者行经髌旁外侧入路治疗。观察对比两组患者围术期情况、术后膝前疼痛程度、膝关节功能、活动度以及术后并发症发生情况。结果两组患者手术时间、住院时间、术中出血量比较,差异有统计学意义(P<0.05)。术后7 d,研究组膝前疼痛程度评分低于参照组,差异有统计学意义(P<0.05)。术后,研究组患者关节活动度、HSS评分优于参照组,差异有统计学意义(P<0.05);两组术后股胫角对比,差异无统计学意义(P>0.05)。研究组术后并发症发生率(50.0%)低于参照组(71.1%),差异有统计学意义(P<0.05)。结论髌旁外侧入路在严重膝外翻畸形全膝关节表面置换术中不仅可以降低手术时间、术中出血量、住院时间,并且在降低患者术后疼痛、膝关节活动度、膝关节功能等方面具有显著的效果。Objective To analyze the application effect of lateral paratellatellar approach and medial paratellatellar approach in total knee replacement with severe valgus deformity.Methods A total of 150 patients who received treatment for severe genu valgus deformity in Dongying People's Hospital from June 2017 to May 2021 were selected randomly as the research objects,and were divided into the control group(76 cases)and the study group(74 cases)according to different surgical methods.Patients in the control group were treated by the paratellomedial approach,and patients in the study group were treated by the transolateral paratellolateral approach.The perioperative conditions,postoperative preknee pain,knee function,range of motion and postoperative complications were observed and compared between the two groups.Results Comparison of surgical duration,hospital stay,and intraoperative bleeding between the two groups,and the difference was statistically significant(P<0.05).The anterior knee pain score of the study group was lower than that of the reference group 7 days after surgery,and the difference was statistically significant(P<0.05).After surgery,the range of motion and HSS score in the study group were better than those in the reference group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in femoral tibial Angle between the two groups(P>0.05).The incidence of postoperative complications in the study group(50.0%)was lower than that in the reference group(71.1%),and the difference was statistically significant(P<0.05).Conclusion The parapatellar lateral approach is the preferred surgical approach for total knee surface replacement with severe genu valva,which can not only reduce the operation time,intraoperative blood loss,and hospitalization period,but also significantly reduce postoperative pain,knee range of motion,and knee function.

关 键 词：膝外翻畸形 全膝关节表面置换术 髌旁外侧入路 疼痛 膝关节活动度 

分 类 号：R816.8[医药卫生—放射医学]