微创人工膝关节单髁置换治疗膝骨性关节炎临床疗效分析

发布时间：2018-01-19 20:54

本文关键词： 膝关节骨性关节炎单髁置换　出处：《中国医学创新》2016年34期 　论文类型：期刊论文

【摘要】：目的:探讨微创人工膝关节单髁置换治疗膝关节骨性关节炎短期临床疗效及手术技巧。方法:回顾性分析2014年4月-2016年3月本科收治膝关节骨性关节炎内侧间室严重病变患者18例,所有患者行微创人工膝关节单髁置换术,记录手术时间、术中出血量、术前及术后血红蛋白变化、术后切口感染、膝关节假体松动、下沉、假体周围骨折、髌前疼痛、膝关节屈曲及内翻畸形矫正等情况,采用HSS膝关节功能评分对术前及术后膝关节功能进行评价。结果:所有患者术后均获得随访,随访时间6~23个月,平均14.6个月。膝关节内侧疼痛缓解,除1例出现关节感染,其他无假体松动、下沉、假体周围骨折、膝关节髌前疼痛等发生。术前膝关节屈曲角度100°~110°,术后120°~135°;术前内翻角度0°~9°,术后0°~3°;术前HSS评分为70分,术后为93分,优良率94%。本组病例手术时间60~100 min,平均(82.00±5.62)min;术中出血量80~260 m L,平均(150.00±40.67)m L;术前血红蛋白115~132 g/L,平均124.3 g/L,术后106~127 g/L,平均118.2 g/L。本组患者手术前后各观察指标比较,差异均有统计学意义(P0.05)。结论:在严格掌握适应证情况下,微创膝关节单髁置换治疗膝关节内侧间室病变骨性关节炎患者手术创伤小,手术时间短,术中出血少,术后隐性失血少,屈曲挛缩及内翻畸形矫正明显,保留骨量多,并发症少,是一种不错的选择。
[Abstract]:Objective: to investigate the short-term clinical effect and surgical techniques of minimally invasive single condylar replacement for osteoarthritis of the knee. From April 2014 to March 2016, 18 cases of severe lesions in medial compartment of knee osteoarthritis were retrospectively analyzed. All patients underwent minimally invasive single condylar replacement of the knee joint to record the operation time, intraoperative blood loss, preoperative and postoperative hemoglobin changes, postoperative incision infection, knee joint prosthesis loosening, sinking, periprosthetic fracture. Pre-patellar pain, knee flexion and varus correction were evaluated by HSS knee function score before and after operation. Results: all patients were followed up after operation. The follow-up time ranged from 6 to 23 months (mean 14.6 months). The medial knee joint pain was relieved, except for one case with joint infection, no prosthesis loosening, sinking, and fracture around the prosthesis. The flexion angle of knee joint was 100 掳to 110 掳before operation and 120 掳to 135 掳after operation. The varus angle was 0 掳(9 掳) before operation and 3 掳(0 掳) after operation. The HSS score was 70 points before operation and 93 points after operation. The excellent and good rate was 940.The operation time was 60 ~ 100 minutes, with an average of 82.00 卤5.62 minutes. The volume of blood loss during operation was 80 ~ 260mL, with an average of 150.00 卤40.67mL; Preoperative hemoglobin 115g / L 132g / L, mean 124.3 g / L, postoperative 106g / L 127g / L. The average value of 118.2 g / L was 118.2 g / L before and after operation, and the difference was statistically significant (P 0.05). Conclusion: under the condition of strictly grasping the indication, there is a significant difference between the two groups before and after operation. Minimally invasive single condylar replacement for the treatment of osteoarthritis patients with medial compartment disease of the knee joint has less operative trauma, shorter operative time, less bleeding during operation, less recessive blood loss after operation, and obvious correction of flexion contracture and varus deformity. It is a good choice to retain more bone mass and less complications.
【作者单位】：云南省普洱市人民医院;
【分类号】：R687.4
【正文快照】： 1云南省普洱市人民医院云南普洱665000Clinical Efficacy Analysis of Minimally Invasive Unicondylar Knee Arthroplasty in the Treatment ofKnee Osteoarthritis/JIN Yu-lin,ZHANG Wei,LI Xiao-peng.//Medical Innovation of China,2016,13(34):054-058随着人口老龄化,膝

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