内轴型与后稳定型假体对膝骨性关节炎患者置换术后恢复和并发症发生风险的影响  

Effects of medial-axis prosthesis and posterior-stabilized prosthesis on postoperative recovery and risk of complications in patients with knee osteoarthritis

作　　者：高振华 钱军 邹永刚 李旭伟 GAO Zhenhua;QIAN Jun;ZOU Yonggang;LI Xuwei(Department of Orthopedics,Zhangye People’s Hospital Affiliated to Hexi University,Zhangye Gansu 734000,China)

机构地区：[1]河西学院附属张掖人民医院骨科,甘肃张掖734000

出　　处：《临床与病理杂志》2023年第5期936-943,共8页Journal of Clinical and Pathological Research

基　　金：张掖市科技计划项目(ZY2022BJ01)。

摘　　要：目的:对比内轴型(medial pivot,MP)、后稳定型(posterior cruciate-stabilizing,PS)假体对膝关节骨性关节炎(knee osteoarthritis,KOA)患者置换术后恢复、并发症发生风险的影响。方法:选取2020年1月至2022年6月在河西学院附属张掖人民医院接受全膝关节置换术(total knee arthroplasty,TKA)治疗的KOA患者105例,采用随机数表法分为观察组(53例)与对照组(52例),其中观察组患者采用MP假体,对照组患者采用PS假体。检测对比2组患者手术前后膝关节X线检测结果、西安大略和麦克马斯特大学(Western Ontario and McMaster Universities,WOMAC)骨关节炎指数、膝关节评分系统(knee scoring system,KSS)得分,同时记录2组患者术后并发症发生情况。结果:术后2组患者术后的关节面夹角(femorotibial facet angle,FTFA)均降低为0°,同时2组患者WOMAC骨关节炎量表僵硬、关节功能子量表得分差异均无统计学意义(均P>0.05)。术后,观察组患者患侧髋膝踝角(hip knee ankle angle,HKAA)、KSS子量表得分均高于对照组(均P<0.05)。观察组患者术后并发症总发生率低于对照组(P<0.05)。结论:相比于PS假体,KOA患者TKA应用MP假体更加符合膝关节的生物学解剖结构,同时患者术后膝功能恢复情况更佳,且可降低并发症总发生率。Objective:To compare the effects of medial-axis type(MP)and posterior-stabilized type(PS)of prosthesis on the postoperative recovery and risk of complications in patients with knee osteoarthritis(KOA).Methods:A total of 105 patients with KOA who underwent total knee arthroplasty(TKA)in Zhangye People’s Hospital Affiliated to Hexi University between January 2020 and June 2022 were selected,who were divided into an observation group(n=53)and a control group(n=52)by random number table method.Patients in the observation group received MP prosthesis,while patients in the control group received PS prosthesis.The knee joint X-ray examination results,Western Ontario and McMaster University(WOMAC)osteoarthritis index,and knee scoring system(KSS)were compared between the 2 groups before and after the operation.The postoperative complications of the 2 groups were also recorded.Results:After the operation,the articular surface angle(FTFA)of the 2 groups was reduced to 0°,and there was no difference in the subscale scores of WOMAC osteoarthritis stiffness and joint function between the 2 groups(both P>0.05).After the operation,the scores of hip knee ankle angle(HKAA)and KSS subscale of patients in the observation group were higher than those in the control group(both P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion:Compared with PS prosthesis,the application of MP prosthesis in TKA for KOA patients is more in line with the biological anatomical structure of knee,and the postoperative recovery of knee function is better,and the total incidence of complications can be reduced.

关 键 词：膝骨性关节炎 全膝关节置换术 内轴型 后稳定型 膝关节评分 并发症 

分 类 号：R687.4[医药卫生—骨科学]