胫骨假体在牛津单髁置换过程中的最优旋转角度  

Optimal rotational alignment of the tibial component during Oxford unicompartmental knee arthroplasty

作　　者：刘宁 孙英晋 黄珑 冯硕 陈向阳 Liu Ning;Sun Yingjin;Huang Long;Feng Shuo;Chen Xiangyang(Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China)

机构地区：[1]徐州医科大学附属医院,江苏省徐州市221000

出　　处：《中国组织工程研究》2025年第33期7158-7164,共7页Chinese Journal of Tissue Engineering Research

基　　金：徐州医科大学附属医院医疗新技术项目(2023301010),项目负责人:陈向阳。

摘　　要：背景:膝关节单髁置换可有效治疗内侧膝骨关节炎,胫骨假体的正确轴向旋转角度对于确保最佳手术成果至关重要。目的:评估胫骨假体轴向旋转角度对内侧膝骨关节炎患者活动平台单髁置换后短期疗效的影响。方法:选择2021年2月至2023年2月在徐州医科大学附属医院行Oxford活动平台单髁关节置换的91例患者为研究对象,根据术后CT测量胫骨假体相对于Akagi线的旋转角度结果进行分组,A组内旋大于0°,B组外旋0°-5°,C组外旋大于5°,记录各组患者术前与术后末次随访的膝关节活动度、牛津膝关节评分及人工关节遗忘指数等指标并进行对比。结果与结论:①术后末次随访,牛津膝关节评分B组明显低于A组(P=0.003)和C组(P=0.025),膝关节活动度B组高于A组(P=0.011)和C组(P=0.024),人工关节遗忘指数B组高于A组(P=0.001)和C组(P=0.049);②末次随访C组人工关节遗忘指数高于A组,差异有显著性意义(P=0.044);③术后随访12-36个月,B、C组分别有2例和7例患者发生术后膝关节疼痛,两组之间差异有显著性意义(P=0.033);④结果证实,活动平台单髁关节置换后,胫骨假体旋转角处于外旋0°-5°时可以取得较好的短期临床疗效,应避免术中胫骨假体旋转不良。BACKGROUND:Unicompartmental knee arthroplasty effectively addresses medial knee osteoarthritis.The accurate tibial component rotational alignment is crucial to ensure the best surgical outcome.OBJECTIVE:To assess the impact of tibial component rotational alignment on short-term outcomes after unicompartmental knee arthroplasty in medial knee osteoarthritis patients.METHODS:From February 2021 to February 2023,91 patients who underwent mobile‑bearing unicompartmental knee arthroplasty in Affiliated Hospital of Xuzhou Medical University were selected.According to the rotational alignment of tibial prosthesis relative to Akagi’s line measured by postoperative CT,the patients were divided into three groups.Group A had internal rotation greater than 0°,group B had external rotation from 0°to 5°,and group C had external rotation greater than 5°.The knee range of motion,Oxford knee score,and forgotten joint score were recorded and compared among three groups preoperatively,at the last follow-up after surgery.RESULTS AND CONCLUSION:(1)At the last follow-up after surgery,the Oxford knee score of group B was significantly lower than that of group A(P=0.003)and group C(P=0.025).The knee range of motion of group B was higher than that of group A(P=0.011)and group C(P=0.024),and the forgotten joint score of group B was higher than that of group A(P=0.001)and group C(P=0.049).(2)The forgotten joint score in group C was significantly higher than that in group A at the last follow-up(P=0.044).(3)Patients were followed up for 12-36 months after arthroplasty.There were 2 and 7 cases of postoperative knee pain in groups B and C,and the difference was statistically significant(P=0.033).(4)It is indicated that external rotation of the tibial prosthesis by 0°-5°is ideal for achieving satisfactory short-term clinical outcomes,so we should avoid intraoperative tibial prosthesis malrotation.

关 键 词：单髁置换 膝骨关节炎 胫骨假体旋转角 膝关节活动度 临床疗效 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R687.4