中重度膝外翻畸形膝关节不稳定患者初次全膝关节置换术中应用髁限制垫片的疗效  

Observation of the effect of a condylar restraint pad in patients with unstable knee joints during primary total knee arthroplasty for moderate and severe genu valgum deformity

作　　者：李慧佳 陈涵 管骏锋 梁杰 方雨欣 李文波[2] LI Huijia;CHEN Han;GUAN Junfeng;LIANG Jie;FANG Yuxin;LI Wenbo(Fujian Medical University,Fuzhou 350004,China;Depaterment of Orthopaedics,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学,福州350004 [2]福建医科大学附属第一医院骨科,福州350005

出　　处：《中华骨与关节外科杂志》2024年第5期431-436,共6页Chinese Journal of Bone and Joint Surgery

基　　金：福建省自然科学基金面上项目(2022J01219)。

摘　　要：目的:探讨中重度膝外翻畸形膝关节不稳定患者初次全膝关节置换术(TKA)中应用髁限制垫片的疗效。方法:选取2015年1月至2022年6月行初次TKA术中采用髁限制垫片治疗的中重度膝外翻畸形患者30例作为TKA+垫片组,选取同期收治的基线资料相匹配的仅采用TKA治疗的中重度膝外翻畸形患者30例作为TKA组,比较两组患者的手术情况、血常规、膝关节功能及关节活动度恢复情况、股胫角的变化情况,分析两组患者的并发症发生情况及总发生率。结果:TKA+垫片组患者手术时间长于TKA组(P<0.05);两组患者总失血量、术中尿量、术后引流量比较,差异无统计学意义(P均>0.05);两组患者术前及术后24 h、72 h 3个时间点进行外周血白细胞(WBC)计数、血红蛋白(Hb)水平比较,差异无统计学意义(P均>0.05)。TKA+垫片组患者术后3个月、6个月美国膝关节协会评分(KSS)临床评分、功能评分和纽约特种外科医院(HSS)评分均显著高于TKA组,术后6个月Feller髌骨评分高于TKA组(P均<0.05);TKA+垫片组患者在术后3个月膝关节活动度优于TKA组、膝关节股胫角小于TKA组(P均<0.05);TKA+垫片组患者的并发症总发生率(10.00%)与TKA组(16.67%)比较,差异无统计学意义(P>0.05)。结论:中重度膝外翻畸形膝关节不稳定患者初次TKA术中应用髁限制垫片有助于提升术后膝关节功能恢复水平、改善膝关节的活动水平。Objective:To investigate the effect of condylar restraint pads on primary total knee arthroplasty(TKA)in patients with moderate and severe genu valgum deformity and knee instability.Methods:30 patients with moderate to severe genu valgum deformity who underwent total knee arthroplasty(TKA)with condylar restraint inserts were included in the observation group,and 30 patients with moderate and severe genu valgum deformity who underwent only TKA were included in the control group for retrospective analysis.Operation indicators,knee joint function scores,and knee joint range of motion changes in the femoral tibial angle and comparisons of the incidence of complications between the two groups.Results:Patients in the observation group had longer surgical durations than those in the control group(P<0.05).There was no statistically significant difference between the observation group and the control group in terms of surgical bleeding volume,intraoperative urine volume,or postoperative drainage volume(all P>0.05).The peripheral blood WBC and Hb levels of patients in the observation group and control group before surgery,24 hours after surgery,and 72 hours after surgery were compared at three time points,and the differences were not statistically significant(all P>0.05).The KSS clinical score,KSS functional score,and HSS score of the observation group patients were significantly greater than those of the control group patients at 3 and 6 months after surgery.The Feller patellar score of the observation group patients at 6 months after surgery was significantly greater than that of the control group patients(all P<0.05).At 3 months postoperatively,patients in the observation group exhibited superior knee joint mobility and a smaller knee joint femorotibial angle than those in the control group(all P<0.05).The surgical complication rate of 10.00% in the observation group was not significantly different from that of 16.67% in the control group(all P>0.05).Conclusions:The use of a condylar restraint pad during the initial tot

关 键 词：膝外翻 畸形 膝关节不稳 全膝关节置换术 髁限制垫片 膝关节功能 

分 类 号：R687[医药卫生—骨科学]