屈曲型膝内翻患者初次全膝置换术中内侧挛缩组织松解的程序化处理  

Programmed release of medial soft tissue contracture in patients with flexion deformity of varus knees during initial total knee replacement

作　　者：周红星 成小辉 袁祥生 Zhou Hongxing;Cheng Xiaohui;Yuan Xiangsheng(The Second Department of Orthopedics,Pingdingshan Medical District,the 989th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army,Pingdingshan 467000,Henan,China)

机构地区：[1]中国人民解放军联勤保障部队第九八九医院平顶山医疗区骨二科,河南平顶山467000

出　　处：《中国现代手术学杂志》2023年第2期104-109,共6页Chinese Journal of Modern Operative Surgery

摘　　要：目的总结评估程序化松解处理内侧挛缩组织在屈曲型膝内翻患者初次全膝置换术中的临床疗效。方法回顾性分析2015年3月至2017年3月我院收治的68例(82膝)屈曲型膝内翻患者,其中男21例(26膝),女47例(56膝),年龄61~78岁,均采用全膝关节置换术治疗。所有患者均由同一医生主刀完成,术中程序化处理内侧挛缩组织。记录术前和末次随访的膝关节功能评分(knee society score,HSS)、疼痛目测类比评分(visual analogue score,VAS)、膝关节伸屈活动度和膝关节内翻角。观察X线片表现,评估膝关节假体位置。结果均获随访,随访时间5年以上。68例患者未出现感染、松动和假体周围骨折等并发症。与术前比较,末次随访时的KSS、VAS、膝关节伸屈活动度和膝关节内翻角有明显改善,差异均有统计学意义(P<0.05)。末次随访X线片显示假体位置良好。结论在初次全膝关节置换治疗屈曲型膝内翻患者中,程序化处理内侧挛缩组织可达到创伤适度、有效平衡、并发症少和重建理想的膝关节功能的目的。Objective To summarize and evaluate the clinical effect of programmed release of medial soft tissue contracture in the patients of the initial total knee replacement of varus knees with flexion deformity.Methods A retrospective analysis was made on 68 patients(82 knees)with flexion varus knee admitted to our hospital from March 2015 to March 2017,including 21 males(26 knees)and 47 females(56 knees),aged 61~78 years.All patients were treated with total knee replacement.All patients were operated by the same doctors.The medial soft tissue contracture was loosened in a sequential manner during the operation.A 5-year follow-up was performed without missing cases.The knee society score(KSS),the visual analogue score(VAS),the range of extension-flexion and the knee varus angle was recorded before operation and at the last follow-up.And the position of prosthesis was evaluated.Results There were no complications such as infection,loosening or periprosthetic fractures during 5 years of follow-up.There was significantly difference of KSS,VAS,the range of extension-flexion and the knee varus angle at the last follow-up,comparing with that before operation(P<0.05).The X-ray film at the last follow-up showed that the position of the prosthesis was good.Conclusion In the treatment of flexion deformity of varus knees with the initial total knee arthroplasty,programmed release of medial soft tissue contracture can achieve the purpose of temperate trauma,effective balance,less complications and reconstruction of ideal knee joint function.

关 键 词：膝关节 膝内翻 全膝关节置换术 软组织平衡 膝关节功能重建 

分 类 号：R687.4[医药卫生—骨科学]