旋转平台和固定平台型假体在初次行人工全膝关节置换术的近期疗效对比研究

发布时间：2018-06-02 03:10

  本文选题：人工全膝关节置换术 + 旋转平台　； 参考：《大连医科大学》2017年硕士论文

【摘要】：目的:分析比较旋转平台型假体(mobile-bearing prosthesis,MB)和固定平台型假体(fixed-bearing prosthesis,FB)在人工全膝关节置换术(Total knee arthroplasty,TKA)术后的近期疗效。比较两种不同假体治疗膝关节骨关节炎(knee osteoarthritis)在改善膝关节疼痛,纠正畸形,重建功能等方面的差异,为临床更好的选择假体提供依据。方法:回顾性分析比较2014年1月—2014年12月在我院诊断为晚期膝关节骨关节炎并行初次TKA的患者,共118例病例(139膝),根据选用假体不同分为:旋转平台组35例(40膝);固定平台组83例(99膝)。术后进行定期门诊复诊或电话跟踪,比较旋转平台组患者与固定平台组患者术前及末次随访时的美国特种外科医院(Hospital of Special Surgery,HSS)评分、美国膝关节学会(Knee Society Scoring System,KSS)评分和膝关节的活动度(Range of motion,ROM)以及术后影像学资料、并发症等情况。两组所有数据均采用SPSS19.0软件对两种不同类型假体在TKA术后近期的临床疗效分析对比,P0.05则认为差异具有统计学意义。结果:所纳入研究的膝关节置换患者有28例失访,余患者均取得了随访并配合完成各项评估指标,两组患者术前的性别、年龄、病程、高血压病、糖尿病等既往史方面均无统计学差异,两种假体均未发生假体的松动、衬垫磨损或脱出等需进行翻修术的病例。影像学所见两组患者的假体位置及力线良好,未见假体周围透亮带而行翻修术。到末次随访时:旋转平台组患者的HSS评分为92.9±5.8,KSS评分为91.5±4.2,ROM为118.67±21.96;固定平台组的HSS评分为93.4±6.1,KSS评分为92.3±4.1,ROM为115.67±20.52。术后末次随访时两种不同假体选择的患者的HSS评分、KSS评分、ROM评分较术前均得到明显的提高,具有统计学意义(P0.05),旋转平台组与固定平台组两者之间的术后近期疗效对比差异无统计学意义(P0.05)。结论:根据本次随访对比研究结果显示:旋转平台型假体与固定平台型假体治疗膝关节晚期骨关节炎均可获得良好的疗效,术后近期疗效无统计学差异。
[Abstract]:Objective: to compare the short-term effects of mobile-bearing prosthesis (Mobe-bearing) and fixed-bearing prosthesis (FBs) on total knee arthroplasty (TKAA) after total knee arthroplasty (TKA). To compare the difference of two kinds of prostheses in improving knee pain, correcting deformity and rebuilding function in knee osteoarthritis, and providing evidence for clinical choice of prosthesis. Methods: from January 2014 to December 2014, patients with advanced knee osteoarthritis and initial TKA in our hospital were retrospectively analyzed and compared. A total of 118 cases were divided into two groups according to the selection of prosthesis: rotation platform group (35 cases) and fixed platform group (83 cases). The patients in the rotating platform group and the fixed platform group were compared with those in the United States special surgery hospital of Special Surgeryn HSS scores before and after the last follow-up, the patients were followed up by regular outpatient consultation or telephone follow-up after operation, and the scores were compared between the patients in the rotating platform group and the fixed platform group. The American Society of knee Joint (AKS) score of knee Society Scoring system and the range of motion of knee joint, the imaging data and complications after operation, and so on. All the data of the two groups were analyzed by SPSS19.0 software in the short term after TKA. The results showed that the difference was statistically significant (P0.05). Results: Twenty-eight patients with knee arthroplasty were involved in the study. All the remaining patients were followed up and completed various evaluation indexes. Gender, age, course of disease, hypertension before operation in both groups. There was no statistical difference in the past history of diabetes mellitus and no loosening of prosthesis was found in the two kinds of prostheses. The position and force line of the prosthesis were good in the two groups, and no bright zone around the prosthesis was seen. At the last follow-up, the HSS score of the patients in the rotating platform group was 92.9 卤5.8m and the HSS score in the fixed platform group was 118.67 卤21.96.The HSS score of the fixed platform group was 92.3 卤4.1mm and 115.67 卤20.52 respectively. At the last follow-up, the HSS score and the ROM score of the patients with two different prosthesis choices were significantly higher than those of the patients before operation. There was no significant difference in the short-term curative effect between the rotating platform group and the fixed platform group. Conclusion: according to the results of this follow-up study, the results show that the rotary platform prosthesis and the fixed platform prosthesis can obtain good curative effect in the treatment of advanced osteoarthritis of knee joint, but there is no statistical difference in the short-term curative effect after operation.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4
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本文编号：1967086