无定位杆胫骨近端切骨引导装置在全膝关节置换术中的应用  

Application of proximal tibial osteotomy guide device without locating rod in total knee arthroplasty

作　　者：储小兵[1] 卢建华[1] 金敏伟 吴志鹏 杨扬 CHU Xiao-bing;LU Jian-hua;JIN Min-wei;WU Zhi-peng;YANG Yang(Dept of Orthopaedics,the First Affiliated Hospital of Zhejiang Chinese Medical University,Zhejiang Provincial Hospital of Chinese Medicine,Hangzhou,Zhejiang 310006,China)

机构地区：[1]浙江中医药大学附属第一医院(浙江省中医院)骨科,浙江杭州310006

出　　处：《临床骨科杂志》2024年第2期190-194,共5页Journal of Clinical Orthopaedics

基　　金：浙江省卫健委卫生健康新技术产品研发项目(编号:2021PY055)。

摘　　要：目的探讨无定位杆胫骨近端切骨引导装置在全膝关节置换术中的应用效果。方法将无定位杆胫骨近端切骨引导装置用于40例全膝关节置换术患者的切骨定位。记录胫骨假体内外翻角误差和胫骨假体后倾角误差(均为与术前计划的差值)、术后并发症发生情况、膝关节屈曲活动度、疼痛VAS评分、膝关节HSS评分。结果患者均获得随访,时间12~56(28.2±6.1)个月。术后X线片显示胫骨假体内外翻角误差0.3°~1.7°(1.0°±0.2°),胫骨假体后倾角误差1.1°~3.0°(2.0°±0.4°)。切口均一期愈合。术后无假体松动、移位及深部感染、深静脉血栓、肺栓塞、神经血管损伤等并发症发生。末次随访时,患者均可完全负重行走,步态正常;膝关节屈曲活动度、疼痛VAS评分、膝关节HSS评分均较术前改善(P<0.05)。结论无定位杆胫骨近端切骨引导装置用于全膝关节置换术操作方便、技术可靠。Objective To investigate the application effect of proximal tibial osteotomy guide device without locating rod in total knee arthroplasty(TKA).Methods The proximal tibial osteotomy guide device without locating rod was used for osteotomy localization of 40 cases undergoing TKA.The error value of varus-valgus angles and posterior slope of tibial prosthesis(both were difference from preoperative plan),the incidence of postoperative complications,knee flexion range of motion,pain VAS and knee HSS score were recorded.Results All patients were followed up for 12~56(28.2±6.1)months.Postoperative X-ray showed that the varus-valgus angle error of tibial prostheses was 0.3°~1.7°(1.0°±0.2°),and the posterior slope error of tibia prostheses was 1.1°~3.0°(2.0°±0.4°).All wounds healed normally.After surgery,there was no complications such as loosening and displacement of the prostheses,deep infection,deep vein thrombosis,pulmonary embolism,neurovascular injury.At the last follow-up,all patients could walk with full weight-bearing,with normal gait.Knee flexion motion,pain VAS and knee HSS score were improved than the preoperation(P<0.05).Conclusions Proximal tibial osteotomy guide device without locating rod is easily operated and reliable technique for the TKA.

关 键 词：膝关节置换术 手术器械 手术技术 胫骨切骨 

分 类 号：R687.4[医药卫生—骨科学] R687.3[医药卫生—外科学]