膝关节单髁置换术胫骨假体术前定位的临床研究

发布时间：2018-09-06 10:49

【摘要】：[目的]探究膝关节单髁置换术胫骨假体精准定位的方法及其对临床疗效的影响。[方法]2014年6月~2014年12月,116例膝关节内侧间室骨性关节炎患者,随机分成两组进行单髁置换术,术前定位组60膝,传统手术组56膝。术前定位组采用术前定位方法,即调整胫骨截骨导向器杆冠状面与胫骨嵴平行、矢状面远端距离皮肤1.80cm进行胫骨平台截骨;传统手术组采用牛津MP操作手册推荐的方法,即胫骨导向器在两个平面上均与胫骨长轴平行进行胫骨平台截骨。测量比较两组患者术后胫骨假体内外翻角(TCVA),胫骨假体后倾角(TCPSA)及HSS评分。[结果]术后平均随访12个月,术前定位组和传统手术组术后的胫骨假体内外翻角度分别为(0.92±1.81)°和(1.61±2.51)°(t=-1.072,P=0.288),胫骨假体后倾角度分别为(6.91±0.85)°和(7.32±1.73)°(t=-1.081,P=0.284),两组之间差异均无统计学意义,但术前定位组的胫骨假体内外翻角及后倾角更接近0°和7°,并且离散度小,更加精准。两组间术前、术后2周、6个月和1年的HSS评分差异均无统计学意义(P0.05)。[结论]:本研究采用的术前定位方法能提高单髁置换术胫骨假体定位精确性,并取得了满意的临床效果。
[Abstract]:Objective: to investigate the accurate localization of tibial prosthesis in single condyle replacement of knee joint and its influence on clinical efficacy. [methods] from June 2014 to December 2014, 116 patients with medial compartment osteoarthritis of the knee joint were randomly divided into two groups, 60 knees in the preoperative localization group and 56 knees in the traditional operation group. In the preoperative localization group, the tibial plateau osteotomy was performed by adjusting the coronal plane of the tibial osteotomy guide bar parallel to the tibial crest and distance from the distal side of the sagittal plane to the skin 1.80cm. In other words, tibial plateau osteotomy is performed by tibial guiding device parallel to the long axis of tibia in both planes. The posterior tilt angle (TCPSA) and HSS score of tibial prosthesis (TCVA), were measured and compared between the two groups. [results] the mean postoperative follow-up was 12 months. The tibial prosthesis extraversion angles were (0.92 卤1.81) 掳and (1.61 卤2.51) 掳(t _ (-1.072) P _ (0.288) in the preoperative localization group and (7.32 卤1.73) 掳(t ~ (-1.081) P _ (0.284) 掳in the traditional operation group, respectively. The tibial prosthesis retroversion angle was (6.91 卤0.85) 掳and (7.32 卤1.73) 掳(t ~ (-1.081) P ~ (0.284), respectively. There was no significant difference between the two groups. However, the tibial prosthesis in the preoperative positioning group was closer to 0 掳and 7 掳, and the dispersion was smaller and more accurate. There was no significant difference in HSS score between the two groups before operation, 2 weeks, 6 months and 1 year after operation (P0.05). Conclusion: the preoperative localization method used in this study can improve the accuracy of tibial prosthesis localization after monondylar replacement, and obtain satisfactory clinical results.
【作者单位】：上海同济大学附属杨浦医院;
【基金】：上海市卫生局重大科研项目(编号:2013040) 上海市科委引导类项目(编号:13411961400)
【分类号】：R687.4

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