术者偏手性对膝内侧间室固定平台假体单髁置换术假体位置和术后早期膝关节功能的影响  

Effect of surgeon’s handedness on prosthesis position and knee function in medial fixed-bearing unicompartmental knee arthroplasty

作　　者：赵锦伟 杨文江 张钟元 高广凌 姜红江 黄相杰 鞠昌军 ZHAO Jinwei;YANG Wenjiang;ZHANG Zhongyuan;GAO Guangling;JIANG Hongjiang;HUANG Xiangjie;JU Changjun(Department of Orthopedics,Shandong Wendeng Osteopathic Hospital,Shandong Institute of Traditional Chinese Medicine Orthopedics and Traumatology,Weihai,Shandong 264400,China;不详)

机构地区：[1]山东省文登整骨医院骨关节科,山东省中医骨伤研究院,山东威海264400 [2]山东省文登整骨医院放射科,山东威海264400 [3]山东省文登整骨医院骨关节科,山东威海264400

出　　处：《中国骨与关节损伤杂志》2024年第10期1034-1038,共5页Chinese Journal of Bone and Joint Injury

基　　金：山东省中医药高层次人才培育项目(鲁卫函〔2023〕143号);全国名老中医药专家孙文学传承工作室建设项目(国中医药人教函〔2018〕134号)。

摘　　要：目的研究分析术者偏手性对膝内侧间室固定平台假体单髁置换术假体位置和术后早期膝关节功能的影响。方法纳入自2021-08—2022-08采用固定平台假体单髁置换术治疗的61例膝内侧间室骨性关节炎,手术均由同一位右利手医师主刀完成,根据手术侧别分为优势手组(31例)和非优势手组(30例)。比较两组手术时间、术后膝关节功能HSS评分和关节遗忘评分,以及术后股骨假体冠状位角(Femoral coronal angle,FCA)、胫骨假体冠状位角(Tibial coronal angle,TCA)、股骨假体矢状位角(Femoral sagittal angle,FSA)、胫骨假体矢状位角(Tibial sagittal angle,TSA)。结果61例获得至少6个月随访,随访期间未出现感染、假体松动、假体周围骨折并发症。优势手组与非优势手组手术时间、术后6个月膝关节功能HSS评分、术后6个月关节遗忘评分差异无统计学意义(P>0.05)。两组FCA差异无统计学意义(P>0.05),但是优势手组FCA更多位于最佳区域,而且分布较集中。两组FSA差异有统计学意义(P<0.05),优势手组FSA分布更多位于最佳区域,非优势组分布分散且变异度较高。两组TCA、TSA差异无统计学意义(P>0.05),散点图显示两组TCA、TSA分布较均衡。结论膝内侧间室固定平台假体单髁置换术中术者偏手性会影响股骨侧假体位置的安放,而术者偏手性对胫骨侧假体位置和术后早期膝关节功能恢复的影响较小。Objective To investigate and analyze the impact of the surgeon’s handedness on prosthesis position and early post⁃operative knee function in medial fixed-bearing unicompartmental knee arthroplasty(FB-UKA).Methods A total of 61 pa⁃tients with medial compartment osteoarthritis treated with FB-UKA from August 2021 to August 2022 were enrolled.The same right-handed surgeon performed all surgeries.Patients were divided into the dominant hand group(31 cases)and non-dominant hand group(30 cases)based on the operative side.The operative time,hospital for special surgery(HSS)score,forgotten joint score(FJS),femoral coronal angle(FCA),tibial coronal angle(TCA),femoral sagittal angle(FSA),and tibial sagittal angle(TSA)were compared between the two groups.Results All 61 patients were followed up for at least 6 months,and no complications such as infection,prosthesis loosening,or periprosthetic fracture occurred during the follow-up period.There were no statistical⁃ly significant differences in operative time,6-month postoperative HSS and FJS between the two groups(P>0.05).There was no statistically significant difference in FCA between the two groups(P>0.05),but the FCA of dominant hand group was more fre⁃quently located in the optimal range and had a more concentrated distribution in the scatter plot.There was a statistically signifi⁃cant difference in FSA between the two groups(P<0.05),with the FSA in the dominant hand group more frequently located in the optimal range and the FSA distribution of the non-dominant hand group located dispersed and variablein the scatter plot.There were no statistically significant differences in TCA or TSA between the two groups(P>0.05),and scatter plots showed a balanced distribution of TCA and TSA in both groups.Conclusion In medial FB-UKA,the surgeon’s handedness will signifi⁃cantly affect the placement of the femoral prosthesis,but it has little effect on the placement of the tibial prosthesis and the shortterm clinical function of the surgery.

关 键 词：膝内侧间室骨性关节炎 单髁置换术 偏手性 固定平台假体 假体位置 

分 类 号：R687.42[医药卫生—骨科学]