膝关节置换术中胫骨平台内侧骨缺损的不同处理方法效果比较

发布时间：2018-06-15 19:16

本文选题：骨关节炎 + 膝　；参考：《中国全科医学》2017年S1期

【摘要】：目的比较骨水泥填充螺钉加强、自体骨移植螺钉固定和金属垫块组合式胫骨平台假体3种处理方法对膝关节置换术合并胫骨平台内侧骨缺损的临床效果。方法选取2013年1月—2016年1月于郑州市骨科医院行单侧膝关节置换术合并胫骨平台内侧骨缺损的患者52例,根据术中处理方式分为A组(骨水泥填充螺钉加强,24例)、B组(自体骨移植螺钉固定,17例)、C组(金属垫块组合式胫骨平台假体,11例)。比较3组患者手术时间及围术期总失血量,术后膝关节活动度、膝关节KSS评分及术后相关并发症发生情况。结果 3组手术时间和总失血量比较,差异均有统计学意义(P0.05);其中C组手术时间长于A组和B组,总失血量高于A组和B组(P0.05)。3组患者术后第3天、术后2周膝关节活动度比较,差异均有统计学意义(P0.05);其中C组膝关节活动度高于A组和B组(P0.05)。3组患者术后2周、术后3个月和6个月KSS评分比较,差异均有统计学意义(P0.05);其中C组KSS评分高于A组和B组(P0.05)。3组患者均未见明显并发症发生。结论金属垫块组合式胫骨平台假体处理胫骨平台内侧骨缺损手术时间和失血量高于骨水泥填充螺钉加强和自体骨移植螺钉固定,但其有利于胫骨平台的稳定,能促进膝关节活动及获得更好的功能。
[Abstract]:Objective to compare the clinical effects of three treatment methods: cement filled screw, autologous bone graft screw fixation and metal pad combined tibial plateau prosthesis for knee arthroplasty combined with medial tibial plateau bone defect. Methods from January 2013 to January 2016, 52 patients underwent unilateral knee replacement combined with medial tibial plateau bone defect in Zhengzhou Orthopaedic Hospital. According to the intraoperative treatment, group A was divided into two groups: group A (24 cases with bone cement screw augmentation) and group B (17 cases with autologous bone graft screw fixation) and group C (11 cases with metal pad combined tibial plateau prosthesis). The time of operation, total blood loss during perioperative period, postoperative knee motion, knee KSS score and postoperative complications were compared among the three groups. Results there were significant differences in the operation time and total blood loss among the three groups (P 0.05), and the operation time in group C was longer than that in group A and group B, and the total blood loss was higher than that in group A and group B on the 3rd day after operation, and the knee motion at 2 weeks after operation. In group C, the knee motion was higher than that in group A and group B, and the KSS scores were higher in group C than in group A and group B at 2 weeks, 3 months and 6 months after operation, respectively. The KSS score of group C was higher than that of group A and group B (P 0.05). Conclusion the operative time and the amount of blood loss in the treatment of medial tibial plateau defect with metal pad composite tibial plateau prosthesis are higher than that with cement filled screw and autologous bone graft screw, but it is beneficial to the stability of tibial plateau. Can promote knee joint movement and obtain better function.
【作者单位】：河南省郑州市骨科医院;
【分类号】：R687.4

【相似文献】