牛津单髁膝关节置换术后矢状面垫片运动与胫骨后倾角的关系  

Relationship between sagittal gasket movement and posterior tibial inclination after Oxford unicondylar knee replacement

作　　者：魏俊刚 WEI Jungang(Department of Orthopedics,Traditional Chinese Medicine Hospital of Yindu District of Anyang City,Anyang,Henan 455133,China)

机构地区：[1]安阳市殷都区中医院骨科,河南安阳455133

出　　处：《中国医学工程》2025年第3期47-52,共6页China Medical Engineering

摘　　要：目的 探究牛津单髁膝关节置换手术后垫片在矢状面上的动态变化与其对胫骨后倾角的影响。方法 选取2018年1月至2023年12月在安阳市殷都区中医院接受牛津单踝关节置换治疗的膝关节前内侧骨关节炎患者113例。通过回顾性数据分析患者的术前术后评估指标,包括牛津膝关节评分、胫骨平台后倾角和关节活动度。关注术后垫片的运动状况、垫片悬出的频率及其对相关指标的影响。分析垫片后悬出距离、垫片运动距离与垫片位置、胫骨平台后倾角之间的关系。结果 术后患者的牛津膝关节评分和胫骨平台后倾角显著低于术前(P<0.05),而关节活动度差异无统计学意义(P>0.05)。平均垫片运动距离为(27.03±6.03)%,相当于(13.72±4.00) mm。在屈膝135°时,34例患者(30.09%)出现垫片悬出。发生和未发生垫片悬出的患者在135°屈膝时的垫片位置、后悬出距离、垫片运动距离、术后胫骨平台后倾角和倾斜角改变变量比较,差异有统计意义(P<0.05)。屈膝135°时后悬出距离与屈膝135°时垫片位置、垫片运动距离均呈正相关(P<0.05),屈膝135°时后悬出距离与胫骨平台后倾角改变量呈负相关(P<0.05)。垫片运动距离与屈膝0°时垫片位置、术后胫骨平台后倾角、胫骨平台后倾角改变量均呈负相关(P<0.05),垫片运动距离与屈膝135°时垫片位置呈正相关(P<0.05)。结论 牛津式单侧踝关节置换术后,膝关节的功能表现有所改善。观察到约30%的病例中存在垫片后悬现象,且其悬出的幅度与垫片的活动范围有显著关联。虽然垫片悬出未直接影响术后膝关节功能,但可能增加垫片移位的风险,因此建议在执行牛津单踝关节置换手术时,不应过分减小胫骨平台的后倾角。【Objective】To investigate the dynamic changes of the shim on the sagittal plane and its influence on the posterior inclination of the tibia after Oxford unicondylar knee replacement.【Methods】A total of 113 patients with anterior medial knee osteoarthritis who received Oxford single ankle arthroplasty in Traditional Chinese Medicine Hospital of Yindu District of Anyang City between January 2018 and December 2023 were selected.Preoperative and postoperative evaluation indicators including Oxford knee score,tibial plateau posterior inclination angle and joint motion were analyzed retrospectively.Attention was paid to the motion status of the gasket after operation,the frequency of gasket suspension and its influence on related indexes.The relationship between the back hanging distance,the moving distance of the gasket,the position of the gasket and the back tilt angle of the tibial platform was analyzed.【Results】Postoperative Oxford knee score and posterior inclination of tibial plateau were significantly lower than those before surgery(P<0.05),but there was no significant difference in joint motion(P>0.05).The average spacer motion distance is(27.03±6.03)%,equivalent to 13.72±4.00 mm.Gasket suspension occurred in 34 patients(30.09%)at 135°flexion.There were significant differences between patients with and without spacer suspension in spacer position,back suspension distance,spacer movement distance,and postoperative posterior inclination and inclination angle of tibial plateau at 135°flexion(P<0.05).The back suspension distance at 135°was positively correlated with the position and motion distance of the shim at 135°(P<0.05),and the back suspension distance at 135°was negatively correlated with the change of the back inclination of the tibial plateau(P<0.05).The spacer movement distance was negatively correlated with the position of the spacer at 0°,the posterior inclination of the tibial plateau and the change of the posterior inclination of the tibial plateau(P<0.05),and the spacer movement d

关 键 词：牛津单髁膝关节置换术 矢状面 垫片 胫骨 后倾角 

分 类 号：R687.4[医药卫生—骨科学]