髌股关节假体置换术后的近期疗效分析

发布时间：2018-08-27 12:56

【摘要】：目的:回顾性分析髌股关节置换术(patellofemoral arthroplasty,PFA)治疗单纯髌股关节炎(Patellofemoral Osteoarthritis,PFOA)的近期临床疗效,并探讨其手术适应症、手术技巧及相关注意事项等。方法:回顾性研究了2014年2月至2015年12月行髌股关节置换术治疗的8例(8膝)单纯髌股关节炎患者,其中男2例(2膝),女6例(6膝);全部行髌股关节置换术,年龄49-68岁,平均53.5岁;体重48-75Kg,平均62.3Kg。分别测量膝关节最大活动度、进行手术前后WOMAC骨关节炎指数评分(the western Ontario and McMaster universities osteoarthritis index)、AKS(the American knee society)评分、Feller髌骨评分。结果:8例病人术后随访时间4-24月不等,平均15.4月,术后伤口均Ⅰ期愈合,无感染、假体位置不良及假体松动等并发症出现。末次随访患肢功能良好。WOMAC骨关节炎指数评分及AKS评分各自三项评分都有显著性提高,差异具有统计学意义(P0.05)。Feller评分由术前15.6±1.6分提高到25.1±1.4分,膝关节活动度由120.1°±4.3°提高到133.6°±5.3°。结论:对于单纯PFOA的患者,PFA近期疗效满意,相比于全膝关节置换术,手术创伤小、术后恢复快;随着技术的进步PFA假体设计理念的改进、病例选择的优化、手术技术的进步,髌股关节置换术的疗效会越来越让人满意。
[Abstract]:Objective: to retrospectively analyze the short term clinical effect of patellofemoral arthroplasty (patellofemoral arthroplasty,PFA) in the treatment of patellofemoral arthritis (Patellofemoral Osteoarthritis,PFOA), and discuss the indications, operative techniques and related matters needing attention. Methods: a retrospective study of 8 patients (8 knees) with patellofemoral arthritis treated by patellofemoral arthroplasty from February 2014 to December 2015 was conducted, including 2 males (2 knees) and 6 females (6 knees), all of whom underwent patellofemoral arthroplasty (age 49-68 years). The average age was 53.5 years and the weight was 48-75 kg / g, with an average of 62.3 kg / g. The maximal motion of knee joint was measured, and the WOMAC osteoarthritis index score (the western Ontario and McMaster universities osteoarthritis index) / AKS (the American knee society) score) and the patella score (Feller) were performed before and after operation. Results the follow-up time of 8 cases ranged from 4 to 24 months (mean 15.4 months). The wound healed in one stage without infection malposition of the prosthesis and loosening of the prosthesis. At the last follow-up, the scores of osteoarthritis index and AKS score of the affected limbs were significantly improved, the difference was statistically significant (P0.05) .Feller score was increased from 15.6 卤1.6 to 25.1 卤1.4 before operation, and the range of knee motion was increased from 120.1 掳卤4.3 掳to 133.6 掳卤5.3 掳. Conclusion: compared with the total knee arthroplasty, the patients with simple PFOA have a satisfactory short-term curative effect, with less trauma and faster postoperative recovery, with the improvement of PFA prosthesis design concept, the optimization of case selection, and the improvement of surgical technique, with the development of technology, the improvement of PFA prosthesis design, the optimization of case selection, and the improvement of surgical technique. Patellofemoral joint replacement will be more and more satisfactory.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.4

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