屈曲间隙角度测量垫块在全膝关节置换术中的应用  

Application of the angle measurement pad of flexion gap in the treatment of total knee arthroplasty

作　　者：樊宗庆[1] 符东林[1] 潘檀[1] 刘坤 郁长修 聂宇[1] Fan Zongqing;Fu Donglin;Pan Tan;Liu Kun;Yu Changxiu;Nie Yu(Department of Orthopaedics,Fuyang People's Hospital(Fuyang People's Hospital Affiliated to Anhui Medical University),Fuyang 236000,China;Major in Anesthesia,Grade 2021,the First Clinical College of Anhui Medical University,Hefei 230022,China)

机构地区：[1]阜阳市人民医院(安徽医科大学附属阜阳人民医院)骨科,阜阳236000 [2]安徽医科大学第一临床学院麻醉专业2021年级,合肥230022

出　　处：《中华解剖与临床杂志》2023年第8期540-546,共7页Chinese Journal of Anatomy and Clinics

基　　金：阜阳市卫生健康委科研项目(FY2021-12);安徽省阜阳市科技局课题(FK202081027)。

摘　　要：目的探讨屈曲间隙角度测量垫块在全膝关节置换术(TKA)中的应用价值。方法前瞻性随机对照研究。选取2019年2月—2021年12月阜阳市人民医院膝关节骨关节炎患者56例,其中男17例、女39例,年龄59~78(68.5±4.5)岁。56例患者采用简单随机抽样分为观察组和对照组,观察组26例,采用屈曲间隙角度测量垫块辅助完成TKA;对照组30例,采用常规股骨远端外旋3°的测量截骨技术完成TKA。观察指标:(1)比较2组患者性别、年龄、侧别等临床基线资料。(2)比较2组患者手术时间、围手术期出血量,以及术中初始屈曲间隙不平衡(IFA)发生率;观察患者术后假体安装的位置情况及术后切口愈合情况。(3)术后定期随访,观察比较2组患者膝关节屈曲功能受限、膝关节异响等手术并发症发生情况,以及术后3个月膝内翻角、股骨假体旋转误差,术后1年采用膝关节疼痛视觉模拟评分法(VAS)评估膝关节疼痛缓解情况、采用膝关节协会(KSS)评分标准分别评估膝关节临床评分和功能评分、测量膝关节的关节活动度(ROM)评估膝关节活动改善情况。结果(1)2组患者基线资料比较差异均无统计学意义(P值均>0.05)。(2)2组患者均顺利完成手术,手术时间和围术期出血量组间比较,差异均无统计学意义(P值均>0.05);术中观察组IFA发生率为7.7%(2/26),低于对照组的53.3%(16/30),差异有统计学意义(χ^(2)=13.30,P<0.001)。术后复查膝关节正侧位X线片,假体安装的位置良好。患者术后切口均一期愈合。(3)56例患者术后随访14~25(21.0±3.2)个月。随访期间观察组膝关节僵硬1例,对照组膝关节僵硬2例、异响1例,2组总并发症发生率比较差异无统计学意义(χ^(2)=0.14,P=0.710)。术后3个月,观察组股骨假体旋转误差(0.4°±1.7°)小于对照组(1.4°±1.0°),差异有统计学意义(t=2.66,P=0.008);2组间膝内翻角比较差异无统计学意义(t=0.73,P=0.468)。术后1年,观察组VAS评�Objective This study aimed to explore the application value of the angle measurement pad of flexion gap in total knee arthroplasty(TKA).Methods A prospective randomized controlled study was conducted.Fifty-six patients with knee osteoarthritis who were admitted in Fuyang People's Hospital from February 2019 to December 2021 were selected in this study,including 17 males and 39 females,aged 59-78(68.5±4.5)years.Fifty-six patients were divided into observation group and control group by simple random sampling.Twenty-six patients in the observation group were treated with the angle measurement pad of flexion gap to complete TKA.Thirty patients in the control group,the conventional measured resection technique with 3°external rotation of distal femur was used to complete TKA.Outcome measurements:(1)The clinical baseline data such as sex,age,and side were compared between the two groups.(2)The operation time,perioperative blood loss,and the number of initial flexion asymmetry(IFA)cases were compared between the two groups,the position of postoperative prosthesis and wound healing after operation were observed.(3)Regular follow-up was performed to observe the occurrence of operative complications such as limited flexion function and abnormal sound of knee joint during the follow-up period,and the knee varus angle and rotation error of femoral prosthesis were observed 3 months after operation.One year after operation,pain was evaluated by using the visual analogue scale(VAS);clinical and functional scores of the knee joint were evaluated by using the knee society score(KSS),and the range of motion(ROM)of the knee was measured to evaluate the improvement of knee joint activity.The above mentioned indexes were compared between the two groups.Results(1)No significant difference in baseline data was observed between the two groups(all P values>0.05).(2)In addition,no significant difference in operation time and blood loss was found between the two groups(all P values>0.05).Intraoperative IFA was observed in two cases in t

关 键 词：关节成形术 置换 膝 膝关节 骨关节炎 股骨假体旋转力线 截骨术 

分 类 号：R687.4[医药卫生—骨科学]