国产人工膝关节假体治疗膝骨关节炎的中长期随访  

Over ten-year clinical result of domestic TC-Dynamic posterior stabilized knee prosthesis in total knee arthroplasty

作　　者：孙振杰[1,2] 刘瑞波[1,2] 袁一 

机构地区：[1]首都医科大学骨外科学系 [2]北京市第六医院骨科,北京100007

出　　处：《中国骨与关节外科》2015年第3期228-232,共5页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:目前国内使用的人工膝关节假体主要为欧美生产,费用昂贵且不符合国人的膝关节解剖数据。国产TC.Dynamic后稳定型人工膝关节假体根据国人的膝关节解剖数据所研制,其术后早期及5年以上的临床疗效已有相关报道。目的目的:评估国产TC.Dynamic后稳定型人工膝关节假体的中长期临床效果和假体存活状况,分析假体长期存活率以及膝关节功能的影响因素。方法方法:2002年3月至2005年2月应用人工膝关节假体行初次TKA患者84例91膝,共71例75膝获得完整随访。其中国产假体组(应用国产TC.Dynamic后稳定型人工膝关节假体)共35例37膝,男6例6膝,女29例31膝,末次随访时平均年龄(77.1±6.6)岁;进口假体组(应用美国史塞克公司生产的Scorpio single Axis后稳定型人工膝关节假体)共36例38膝,男6例7膝,女30例31膝,末次随访时平均年龄(76.2±6.1)岁。比较两组中获得完整随访资料患者的术后6个月和末次随访的KSS膝评分、功能评分和关节活动度(ROM)等数据。结果结果:共71例75膝获得随访,随访时间为10.1~13.0年,平均(10.8±1.5)年。两组末次随访时的KSS膝评分、功能评分和ROM比较均无统计学差异。国产假体组髌骨外侧支持带松解率为5.4%(2/37),进口假体组为18.4%(7/38),两者比较有统计学差异(P<0.05)。两组病例的X线片均未发现>2 mm的透亮线,下肢力线良好,假体位置满意;均未出现远期感染及脱位的病例。结论结论:使用国产Tc.Dynamic后稳定型人工膝关节假体可以获得良好的长期临床疗效,其设计更适合国人的膝关节解剖特点,价格低廉,适宜推广。Background: Total knee prosthesis made by Europe and America is popular in China now, but it is very expensive and not fit for the anatomic structure of Chinese.Objective: To evaluate long-term clinical outcome and survival of TC-Dynamic domestic prosthesis in total knee arthroplasty(TKA) for OA, and to assess influencing factors of prosthesis survival rate and knee function.Methods: From March 2002 to February 2005, 84 patients(91 knees) underwent TKA. Eventially, 71 patients(75 knees)were followed up. TC-Dynamic domestic prosthesis was used in 35 patients(37 knees) and Scorpio single Axis prosthesis(Stryker, USA) was used in 36 patients(38 knees). In TC-Dynamic group, there were 6 males(6 knees) and 29 females(31knees) with an average age of(77.1±6.6) years. In Scorpio group, there were 6 males(7 knees) and 30 females(31 knees)with an average age of(76.2 ± 6.1) years. The KSS scores, joint function and range of motion(ROM) were evaluated between the two groups at 6 months after operation,as well was at the last follow-up.Results: The average duration of follow-up was(10.8±1.5) years(range, 10.1-13.0 years) in the 71 patients. There were no significant differences in the KSS scores, joint function or ROM between two groups at the last follow- up(P>0.05). The rate of lateral retinacular release in TC-Dynamic group was 5.4%(2/37) and 18.4%(7/38) in Scorpio group(P<0.05). No more than 2 mm X-ray radiolucent line was found in both groups. The line of force of lower limbs and the position of the prosthesis were satisfactory. No infection or dislocation occurred during follow up.Conclusions: Long-term clinical outcome of TKA is good when domestic posterior stabilized prosthesis is implanted. It is more suitable for Chinese patients because of low price and appropriating anatomy.

关 键 词：关节成形术 置换 膝 治疗结果 

分 类 号：R687.4[医药卫生—骨科学] R318.17[医药卫生—外科学]