个体化股骨后髁旋转截骨在全膝关节置换术中的应用  

Application of individualized femoral posterior condylar rotational osteotomy in total knee arthroplasty

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作  者:刘习强 李广彬 张彦伟 LIU Xi-qiang;LI Guang-bin;ZHANG Yan-wei(Department of Orthopedics,Puyang Huimin Hospital,Puyang 457000,Henan,CHINA;Department of Orthopedics,Chinese Medicine Hospital of Puyang,Puyang 457000,Henan,CHINA)

机构地区:[1]濮阳惠民医院骨二科,河南濮阳457000 [2]濮阳市中医医院骨科,河南濮阳457000 [3]濮阳惠民医院骨一科,河南濮阳457000

出  处:《海南医学》2025年第7期971-975,共5页Hainan Medical Journal

基  金:2021年河南省医学科技攻关计划联合攻关项目(编号:LHGJ20210930)。

摘  要:目的研究个体化股骨后髁旋转截骨在全膝关节置换术(TKA)中的应用效果。方法回顾性分析2022年1月至2023年12月濮阳惠民医院收治的85例TKA患者的临床资料,依据不同股骨远端旋转截骨方法将患者分为对照组42例和观察组43例,对照组患者予以股骨后髁线(PCL)外旋3°截骨,观察组患者予以个体化测量股骨后髁角(PCA)截骨。术前及术后6个月,比较两组患者的膝关节协会评分(KSS)、膝关节活动度(ROM)、视觉模拟评分(VAS);比较两组患者术后6个月内的并发症发生情况。结果术前,两组患者的KSS、ROM、VAS评分比较差异均无统计学意义(P>0.05);术后6个月,两组患者的KSS、ROM均较术前增加,且观察组患者的KSS为(90.49±7.82)分,明显高于对照组的(85.77±7.03)分,ROM为(103.27±10.36)°,明显大于对照组的(96.03±9.50)°,差异均有统计学意义(P<0.05);术后6个月,两组患者的VAS评分均较术前下降,且观察组患者的VAS评分为(1.09±0.15)分,明显低于对照组的(2.39±0.29)分,差异均有统计学意义(P<0.05);术后6个月内,观察组患者的并发症总发生率为9.30%,明显低于对照组的26.19%,差异有统计学意义(P<0.05)。结论TKA患者通过个体化测量PCA截骨可有效改善患者膝关节活动度及膝关节功能,缓解患者疼痛,降低并发症发生率。Objective To investigate the application effect of individualized femoral posterior condylar rotational osteotomy in total knee arthroplasty(TKA).Methods A retrospective analysis was conducted on the clinical data of 85 TKA patients admitted to Puyang Huimin Hospital from January 2022 to December 2023.The patients were divided into a control group(42 cases)and an observation group(43 cases)based on different femoral distal rotational osteotomy methods.The control group underwent 3°external rotation osteotomy along the posterior condylar line(PCL),while the observation group underwent osteotomy based on individualized measurement of the posterior condylar angle(PCA).The Knee Society Score(KSS),range of motion(ROM),and Visual Analog Scale(VAS)scores were compared between the two groups before surgery and 6 months postoperatively.The incidence of complications within 6 months after surgery was also compared between the two groups.Results Preoperatively,there were no statistically significant differences in KSS,ROM,or VAS scores between the two groups(P>0.05).At 6 months postoperatively,both groups showed improvements in KSS and ROM compared to preoperative values.The KSS in the observation group was(90.49±7.82)points,significantly higher than(85.77±7.03)points in the control group(P<0.05);ROM was(103.27±10.36)°,significantly greater than(96.03±9.50)°in the control group;both differences were statistically significant(P<0.05).Both groups showed a reduction in VAS scores compared to preoperative values,the VAS score in the observation group was(1.09±0.15)points,significantly lower than(2.39±0.29)points in the control group,with the difference being statistically significant(P<0.05).Within 6 months postoperatively,the total complication rate in the observation group was 9.30%,significantly lower than 26.19%in the control group(P<0.05).Conclusion Individualized PCA osteotomy in TKA patients can effectively improve knee joint mobility and function,alleviate pain,and reduce the incidence of complications.

关 键 词:全膝关节置换术 股骨 后髁线 后髁角 旋转截骨 

分 类 号:R687.4[医药卫生—骨科学]

 

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