膝外翻患者全膝关节置换术中髁限制垫片的辅助应用效果研究  

Effectiveness of condylar constrained inserts in total knee arthroplasty for patients with valgus knee deformity

作　　者：姚鹏举[1] 张先一 周三国[1] YAO Peng-ju;ZHANG Xian-yi;ZHOU San-guo(Department of Orthopaedics,Jiaozuo People's Hospital,Jiaozuo 454002,Henan,CHINA)

机构地区：[1]河南省焦作市人民医院骨科,河南焦作454002

出　　处：《海南医学》2025年第5期672-677,共6页Hainan Medical Journal

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20210113)。

摘　　要：目的探讨髁限制垫片在膝外翻畸形初次全膝关节置换术(TKA)中的应用效果。方法选取2020年5月至2023年5月焦作市人民医院收治的86例中重度膝外翻畸形患者作为研究对象,按随机数表法分为对照组和观察组各43例,对照组患者采用常规TKA手术治疗,观察组患者采用TKA手术+髁限制垫片的治疗方案。比较两组患者的手术时间、术中尿量、总失血量、术后引流量;术前、术后2个月和6个月,采用膝关节功能评分量表(KSS)临床评分和功能评分评价两组患者的膝关节活动功能,比较两组患者术后的膝关节活动度;术后6个月内,比较两组患者的并发症情况;术后6个月,患者进行复查时通过问卷的方法记录患者对治疗的满意度。结果观察组患者的平均手术时间长于对照组,差异有统计学意义(P<0.05),但两组患者的术中尿量、总失血量、术后引流量比较差异均无统计学意义(P>0.05);观察组患者术后2个月和6个月的KSS临床评分分别为(69.12±5.84)分、(83.86±5.98)分,明显高于对照组的(66.24±4.65)分、(80.79±6.08)分,KSS功能评分分别为(63.93±6.31)分、(81.85±5.33)分,明显高于对照组的(59.88±6.17)分、(79.46±5.74)分,差异均有统计学意义(P<0.05);两组患者术后2个月和术后6个月的膝关节活动度均升高,且观察组患者的膝关节活动度分别为(103.98±10.78)°、(118.89±12.44)°,明显大于对照组的(99.25±8.81)°、(113.46±9.98)°,差异均有统计学意义(P<0.05);观察组患者的并发症总发生率为11.63%,略低于对照组的16.28%,但差异无统计学意义(P>0.05);观察组患者对手术的满意度为93.02%,明显高于对照组的76.74%,差异有统计学意义(P<0.05)。结论在中重度膝外翻畸形TKA术中应用髁限制垫片能有效提高患者术后膝关节的功能恢复水平和活动度,降低并发症的发生率,具有较高的临床应用价值。Objective To evaluate the effectiveness of condylar constrained inserts(CCIs)in primary total knee arthroplasty(TKA)for patients with valgus knee deformity.Methods A total of 86 patients with moderate to severe valgus knee deformity admitted to Jiaozuo People’s Hospital from May 2020 to May 2023 were randomized into a control group(n=43)and an observation group(n=43).Patient in the control group underwent conventional TKA,while those in the observation group received TKA with CCIs.The surgical duration,intraoperative urine output,total blood loss,and postoperative drainage volume were compared between the two groups.The knee function was evaluated using the Knee Society Score(KSS)clinical and functional scores before surgery,as well as at 2 and 6 months after surgery.The range of motion(ROM)of the knee was also compared between the two groups.Within 6 months after surgery,the complications were compared,and patients’satisfaction with the treatment was recorded through questionnaires at 6 months after surgery.Results The average surgical duration was longer in the observation group than in the control group(P<0.05).However,there were no statistically significant differences in intraoperative urine output,total blood loss,or postoperative drainage volume between the two groups(P>0.05).The KSS clinical scores at 2 and 6 months after surgery were(69.12±5.84)points and(83.86±5.98)points in the observation group,respectively,significantly higher than(66.24±4.65)points and(80.79±6.08)points in the control group;the KSS functional scores were(63.93±6.31)points and(81.85±5.33)points in the observation group,significantly higher than(59.88±6.17)points and(79.46±5.74)points in the control group;the differences were all statistically significant(P<0.05).The ROM of the knee increased in both groups at 2 months and 6 months after surgery,with the observation group having significantly greater ROM at(103.98±10.78)°and(118.89±12.44)°,respectively,as compared with the control group's(99.25±8.81)°and(113.46±9.98

关 键 词：膝外翻畸形 全膝关节置换术 髁限制垫片 中重度 满意度 并发症 

分 类 号：R687.4[医药卫生—骨科学]