全膝关节置换术中后交叉韧带保留与切除与否的对比研究

发布时间：2018-10-14 13:41

【摘要】：目的比较全膝关节置换术中,对后交叉韧带采取保留与切除两种处理方式的临床疗效。方法回顾性分析2007至2014年度,首都医科大学附属北京天坛医院膝关节骨性关节病患者56例,其中男性21例,女性35例;左侧20例,右侧36例;年龄52~78岁,平均年龄(66.56±10.33)岁,病程6~15年。术中保留后交叉韧带者34人;术中行后交叉韧带切除者22人。比较二者的手术时间、术中出血、膝关节评分及关节活动度等指标。结果 56例患者经12~36个月随访,平均(25.6±7.3)个月。后交叉韧带保留组和后交叉韧带切除组,手术时间分别为(103±21)min、(98±23)min(P0.05);术中出血分别为(361±120)mL、(355±98)mL(P0.05);膝关节评分分别为90.2与88.6分(P0.05);关节活动度分别为伸:-1.0与-2.5(P0.05),屈:111与112(P0.05)。两组手术时间、术中出血、膝关节评分及关节总活动度等差异无统计学意义,但伸展位活动度差异有统计学意义。结论全膝关节置换术中后交叉韧带的保留与否对手术效果影响不大,应依据术中膝关节具体情况以及术者习惯,选择最合适的手术方式。
[Abstract]:Objective to compare the clinical effects of preservation and resection of posterior cruciate ligament in total knee arthroplasty. Methods from 2007 to 2014, 56 patients with osteoarthropathy of knee joint of Temple of Heaven Hospital affiliated to Beijing Capital Medical University were retrospectively analyzed, including 21 males, 35 females, 20 patients on the left side and 36 patients on the right side, with an average age of (66.56 卤10.33) years. The course of disease was 6 ~ 15 years. The posterior cruciate ligament was preserved in 34 cases and the posterior cruciate ligament was resected in 22 cases. The operative time, intraoperative bleeding, knee joint score and joint motion were compared between the two groups. Results 56 patients were followed up for 12 ~ 36 months with an average of (25.6 卤7.3) months. In the posterior cruciate ligament preservation group and posterior cruciate ligament resection group, the operative time was (103 卤21) min, (, 98 卤23) min (, P0.05), the intraoperative bleeding was (361 卤120) mL, (, 355 卤98) mL (, P0.05), the knee joint score was 90.2 and 88.6 (P0.05), and the joint motion was -1.0 and -2.5 (P0.05), flexion: 111,112 (P0.05). There were no significant differences in operation time, intraoperative bleeding, knee joint score and total joint motion between the two groups, but there were significant differences in stretching motion between the two groups. Conclusion the preservation of posterior cruciate ligament in total knee arthroplasty has little effect on the operation effect. The most suitable operation method should be selected according to the specific condition of knee joint and the habit of the operator.
【作者单位】：首都医科大学附属北京天坛医院骨科;
【分类号】：R687.4

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