改良Pie-crusting技术在初次全膝关节置换术内侧松解中的应用
发布时间：2019-07-16 12:22
【摘要】：目的评估改良Pie-crusting技术(简称PC技术)在初次全膝关节置换术(total knee arthroplasty,TKA)内侧松解中应用的安全性和有效性。方法 2014年3月~2016年6月由同一术者采用改良PC技术完成膝内翻畸形初次TKA 30例(34膝)。使用特制带弧形刀柄限宽3 mm、限深5 mm的手术刀进行横行点戳,以紧张部位优先松解的原则,伸直紧时松解内侧副韧带浅层后束纤维及后内侧关节囊,屈曲紧时松解内侧副韧带浅层前束纤维。记录松解前后伸直、屈曲位内外侧间隙值;根据术中测量值分为伸直屈曲均紧张组(10膝)、仅伸直紧张组(13膝)和仅屈曲紧张组(11膝),间隙≤1 mm为软组织平衡,分别计算平衡矫正率。术后定期拍摄患膝负重位片测量下肢力线,记录膝关节活动度(range of motion,ROM)、HSS评分、WOMAC评分,并与术前比较。结果 31膝达到屈伸间隙、内外侧间隙平衡。1膝伸直间隙内外侧相差2 mm,2膝屈曲间隙内外侧相差2 mm,总体平衡矫正率91.2%(31/34)。3例术中应用限制性垫片。未发生因该技术导致的其他并发症。仅伸直紧组松解后屈曲间隙增加中位数1 mm(1~3 mm),仅屈曲紧组松解后伸直间隙增加中位数1 mm(1~2 mm),无统计学差异(Z=-1.118,P=0.264)。术前患者膝关节ROM为83.3°±14.7°,机械轴偏移角度中位数11.5°(7°~32°),HSS评分为(42.7±16.3)分、WOMAC评分为(76.2±8.2)分,术后膝关节ROM为100.7°±14.2°(t=-7.714,P=0.000)、机械轴偏移角度中位数1°(0°~4°)(Z=-5.092,P=0.000)、HSS评分(88.1±9.9)分(t=-21.868,P=0.000)、WOMAC评分(11.4±9.7)分(t=31.726,P=0.000),均较术前明显改善。结论在初次TKA中使用改良PC技术做内侧松解是安全、有效的。仅松解伸直或屈曲位触摸紧张的纤维,也会同时影响两个间隙。
[Abstract]:Objective to evaluate the safety and effectiveness of modified Pie-crusting technique (PC technique) in medial release of primary total knee arthroplasty (total knee arthroplasty,TKA). Methods from March 2014 to June 2016, 30 cases (34 knees) of primary TKA of knee varus deformity were performed by modified PC technique. A special scalpel with arc handle limited width of 3 mm, and depth of 5 mm was used to poke the transverse point. According to the principle of first release of tension part, the superficial posterior bundle fiber of medial collateral ligament and posterior medial joint capsule were loosened when stretching and tight, and the superficial anterior bundle fiber of medial collateral ligament was loosened when flexion was tight. According to the measured values, the tension group (10 knees), only flexion tension group (13 knees) and flexion tension group (11 knees) were divided into two groups, and the balance correction rate was calculated according to the measured values before and after loosening, which were divided into three groups: stretching tension group (13 knees) and flexion tension group (11 knees). The balance correction rate was calculated respectively. The force line of lower extremity was measured by regular knee weight film after operation, and the (range of motion,ROM), HSS score and WOMAC score of knee joint motion were recorded and compared with those before operation. Results 31 knees reached flexion and extension space, and the internal and external space was balanced. 1 the difference between medial and lateral flexion space was 2 mm,2, and the overall balance correction rate was 91.2% (31 鈮，
本文编号：2515071
[Abstract]:Objective to evaluate the safety and effectiveness of modified Pie-crusting technique (PC technique) in medial release of primary total knee arthroplasty (total knee arthroplasty,TKA). Methods from March 2014 to June 2016, 30 cases (34 knees) of primary TKA of knee varus deformity were performed by modified PC technique. A special scalpel with arc handle limited width of 3 mm, and depth of 5 mm was used to poke the transverse point. According to the principle of first release of tension part, the superficial posterior bundle fiber of medial collateral ligament and posterior medial joint capsule were loosened when stretching and tight, and the superficial anterior bundle fiber of medial collateral ligament was loosened when flexion was tight. According to the measured values, the tension group (10 knees), only flexion tension group (13 knees) and flexion tension group (11 knees) were divided into two groups, and the balance correction rate was calculated according to the measured values before and after loosening, which were divided into three groups: stretching tension group (13 knees) and flexion tension group (11 knees). The balance correction rate was calculated respectively. The force line of lower extremity was measured by regular knee weight film after operation, and the (range of motion,ROM), HSS score and WOMAC score of knee joint motion were recorded and compared with those before operation. Results 31 knees reached flexion and extension space, and the internal and external space was balanced. 1 the difference between medial and lateral flexion space was 2 mm,2, and the overall balance correction rate was 91.2% (31 鈮，
本文编号：2515071
本文链接：https://www.wllwen.com/yixuelunwen/waikelunwen/2515071.html
最近更新
教材专著
