全膝关节置换术后股骨假体前屈角对膝关节功能康复的影响  

Effect of flexion angle of femoral prosthesis after total knee arthroplasty on functional rehabilitation of knee joint

作　　者：王浩然 何斌[1] 范磊[1] 王伯尧[1] 秦虎[1] 王云华[1] WANG Haoran;HE Bin;FAN Lei;WANG Boyao;QIN Hu;WANG Yunhua(Department of Orthopaedics,The Second Affiliated Provincial Hospital of Nanjing Medical University,Nanjing,Jiangsu 210011,China)

机构地区：[1]南京医科大学第二附属医院骨科,江苏南京210011

出　　处：《中国骨与关节损伤杂志》2024年第2期139-143,共5页Chinese Journal of Bone and Joint Injury

基　　金：江苏省卫生健康委员会医学科研立项项目(M2020059);江苏省老年健康科研项目(LKM2022007)。

摘　　要：目的观察全膝关节置换术后股骨假体前屈角对患者膝关节功能康复的影响。方法回顾性分析自2021-08—2022-08采用全膝关节置换术治疗的70例膝骨性关节炎,根据术后患膝关节X线正侧位片股骨假体前屈角度进行分组,正常患者术后股骨假体前屈角度5°~7°,35例股骨假体前屈角正常(A组),35例股骨假体前屈角偏大(B组)。两组术前活动情况无明显差异,术中均在规范操作下完成手术,选择相同厂家的膝关节假体系统,假体置入位置、松紧度均无异常,术后采用相同的康复训练方案。比较两组手术时间、术中出血量、膝关节功能HSS评分、疼痛VAS评分、股骨假体俯屈角、胫骨平台后倾角以及膝关节伸直与屈曲活动度。结果70例均获得为期1个月的门诊随访,术后症状均有所改善。两组手术时间、术中出血量比较差异无统计学意义(P>0.05)。A组术后1个月膝关节功能HSS评分为(84.74±4.78)分,B组为(79.89±4.43)分;A组术后1个月膝关节功能HSS评分较B组高,差异有统计学意义(P<0.05)。术后1个月膝关节功能HSS评分等级:A组优16例,良19例;B组优3例,良32例。A组术后1个月疼痛VAS评分为(2.39±0.32)分,B组为(2.91±0.43)分;A组术后1个月疼痛VAS评分较B组低,差异有统计学意义(P<0.05)。A组术后1个月股骨假体俯屈角小于B组,差异有统计学意义(P<0.05)。两组术后1个月胫骨平台后倾角比较差异无统计学意义(P>0.05)。A组术后1个月膝关节伸直活动度优于B组,差异有统计学意义(P<0.05)。两组术后1个月膝关节屈曲活动度比较差异无统计学意义(P>0.05)。结论全膝关节置换术后股骨假体前屈角偏大对患者膝关节结构的稳定以及功能的恢复有着较大的影响,术后股骨假体前屈角正常者无论是症状的缓解程度以及膝关节功能的恢复程度均优于股骨假体前屈角偏大者。Objective To observe the effect of the flexion angle of femoral prosthesis on the functional rehabilitation of knee joint after total knee arthroplasty.Methods Seventy cases of knee osteoarthritis treated by total knee arthroplasty from August 2021 to August 2022 were retrospectively analyzed.They were divided into groups according to the flexion angle of femoral pros⁃thesis in the positive lateral X-ray film of knee joint after operation.The flexion angle of femoral prosthesis after operation of 5°-7°was normal,in 35 patients(group A)and too large in another 35 patients(group B).There was no significant difference in preoperative activities between the two groups.The operation was completed under the standard operation.The knee prosthesis system of the same manufacturer was selected,and there was no abnormality in the placement position and tightness of the pros⁃thesis.The same rehabilitation training scheme was adopted after the operation.The operation time,intraoperative blood loss,HSS score of knee joint function,VAS score of pain,flexion angle of femoral prosthesis,posterior inclination angle of tibial pla⁃teau,extension and flexion range of knee joint were compared between the two groups.Results All 70 cases were followed up for one month,and their symptoms improved after operation.There was no significant difference in operation time and blood loss between the two groups(P>0.05).One month after operation,the HSS score of knee joint function was(84.74±4.78)in group A,and(79.89±4.43)in group B.The HSS score of knee joint function in group A was higher than that in group B one month after operation,and the difference was statistically significant(P<0.05).One month after operation,HSS score of knee joint function:in group A,excellent in 16 cases and good in 19 cases;In group B,3 cases were excellent and 32 cases were good.The VAS score of pain was(2.39±0.32)in group A and(2.91±0.43)in group B one month after operation.The VAS score of pain in group A was lower than that in group B one month after o

关 键 词：膝骨性关节炎 全膝关节置换术 股骨假体 前屈角 

分 类 号：R687.4[医药卫生—骨科学]