胫骨后倾角在全膝关节表面置换术中的临床应用研究

发布时间：2018-09-04 11:28

【摘要】：[目的]探讨胫骨后倾解剖截骨技术在全膝关节表面置换术中的临床应用及术后疗效。[方法]采用前瞻性随机对照研究,选取2013年1月~2013年12月期间采用同一类型的PS假体行单侧全膝关节表面置换的患者80例。按胫骨的后倾截骨方法不同随机抽样分为两组,胫骨后倾解剖截骨组42例,常规7°~10°后倾截骨组38例。比较分析两组患者的手术情况、影像学评估及膝关节功能恢复情况。[结果]80例患者中75例获得随访,两组患者的膝关节畸形得到了矫正,疼痛及活动功能均得到明显改善。解剖组每名患者的术后胫骨后倾角相比术前变化范围较小;常规组患者的术后后倾角变化范围较大,93%集中在7°~10°之间;两组患者术后6周,3、6个月,1年随访的HSS评分,解剖组明显高于常规组,P0.05。[结论]全膝关节表面置换术作为一种成熟的矫形外科手术,对晚期膝骨关节炎疗效确切。使用胫骨后倾解剖截骨的方法能够使术后患者的后倾角与术前趋于一致,较常规后倾截骨能够获得更好的近期临床疗效。
[Abstract]:Objective: to investigate the clinical application and postoperative effect of tibial posterior anatomic osteotomy in total knee joint surface replacement. [methods] A prospective randomized controlled study was conducted in 80 patients who underwent unilateral total knee arthroplasty with the same type of PS prosthesis from January 2013 to December 2013. According to the method of tibial posterior declination, we randomly divided them into two groups: 42 cases in tibial anatomic osteotomy group and 38 cases in routine 7 掳10 掳retroversion osteotomy group. The operation, imaging evaluation and knee function recovery were compared between the two groups. [results] Seventy-five of 80 patients were followed up. The knee deformities of the two groups were corrected, and the pain and motor function were improved obviously. In the anatomic group, the range of postoperative tibial posterior inclination was smaller than that in the preoperative group, the range of postoperative posterior inclination in the routine group was 93%, and the range of postoperative posterior inclination was between 7 掳and 10 掳. The HSS scores of the patients in the two groups were followed up for 3 weeks, 6 months and 1 year after operation. The anatomic group was significantly higher than the routine group (P 0.05). [conclusion] as a mature orthopedic surgery, total knee surface replacement is effective in the treatment of advanced knee osteoarthritis. The method of tibial posterior oblique osteotomy can make the posterior inclination angle of postoperative patients consistent with that of pre-operation, which is better than that of conventional posterior declination osteotomy.
【作者单位】：河北北方学院研究生部外科;中国人民解放军第二五二医院;
【分类号】：R687.4

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