膝关节翻修术后关节线变化对膝关节功能的影响

发布时间：2018-05-16 18:53

本文选题：膝关节翻修术 + 关节线　；参考：《山东医药》2017年16期

【摘要】：目的探讨膝关节翻修术后关节线变化对膝关节功能的影响。方法选择拟行膝关节翻修术患者89例(共89膝),均植入LCCK髁限制性膝关节假体进行膝关节翻修术。术前及术后24个月,根据X线平片检查结果测量关节线,比较关节线变化≤2 mm、2~≤4 mm、4 mm者手术前后膝关节评分、功能评分、Feller髌骨评分及膝关节活动度。比较术中应用或未应用胫骨、股骨金属填充块者的关节线变化及上述膝关节功能相关指标。结果患者术后关节线变化为-4.1~8.9 mm,上移70例、下移19例;关节线变化≤2 mm 23例,2~≤4 mm 35例,4 mm 31例。与术前比较,相同关节线变化者术后膝关节评分、功能评分、Feller髌骨评分及膝关节活动度均升高(P均0.01);但关节线变化≤2 mm及2~≤4 mm者术后膝关节评分、功能评分、Feller髌骨评分均高于关节线变化4mm者(P均0.01)。术中应用股骨金属填充块40例、未应用49例,其术后关节线变化分别为-4.1~7.9(1.9±3.4)、2.2~8.9(3.5±3.4)mm,二者比较P0.05。术中应用胫骨金属填充块14例、未应用75例,二者术后关节线变化比较P0.05。应用股骨金属填充块者术后功能评分、Feller髌骨评分均高于未应用者(P0.05或0.01),应用与未应用胫骨金属填充块者术后膝关节评分、功能评分、Feller髌骨评分、膝关节活动度比较差异均无统计学意义(P均0.05)。结论膝关节翻修术后关节线变化4 mm的患者膝关节功能较差,术中应用股骨金属填充块有利于减小关节线变化及提高膝关节功能,而胫骨金属填充块则无明显作用。
[Abstract]:Objective to investigate the effect of the change of the joint line on the function of the knee joint after the knee arthroplasty. Methods 89 patients (89 knees) were selected for the knee arthroplasty (total 89 knees), and the LCCK condyle prosthesis was implanted into the knee arthroplasty. The joint lines were measured before and 24 months after the operation, and the changes of the joint line were less than 2 mm, 2~ 4 mm, 4 mm before and after operation knee joint score, function score, Feller patellar score and knee joint activity. Compare the changes of the joint line of the tibia and the femoral metal filling block in the operation and the related indexes of the above knee joint function. Results the joint line changes after the operation were -4.1~8.9 mm, 70 cases were moved up, 19 cases were moved down and the joint line changes were changed. < 2 mm > 23 cases, 2~ < 4 mm 35 cases, 4 mm 31 cases. Compared with pre operation, the knee joint score, function score, Feller patellar score and knee joint activity increased (P 0.01), but the knee joint line changes less than 2 mm and 2~ < 4 mm, the function score, and the Feller patellar score were higher than those of the 4mm on the joint line. P 0.01). 40 cases of femoral metal filling block were used during the operation, and 49 cases were not used. The postoperative joint line changes were -4.1~7.9 (1.9 + 3.4) and 2.2~8.9 (3.5 + 3.4) mm respectively. Two were compared with 14 cases of tibial metal filling block in P0.05. operation, 75 cases were not used. The postoperative functional score of femoral metal filling block in P0.05. application was compared with P0.05. after operation, Fel The ler patellar scores were all higher than those of those who were not used (P0.05 or 0.01). There was no significant difference in knee joint score, functional score, Feller patellar score and knee joint activity (P 0.05). Conclusion the knee joint function of patients with 4 mm after knee arthroplasty was poor, and the operation was applied during the operation. The metal filling block of femur is beneficial to reduce the change of the joint line and improve the function of the knee joint, while the tibial metal filling block has no obvious effect.

【作者单位】：北京积水潭医院;
【基金】：国家自然科学基金资助项目(81472139)
【分类号】：R687.4

【相似文献】