术前胫骨力线X线定位对提高膝关节置换术后假体力线的作用

发布时间：2018-04-23 16:59

本文选题：膝关节置换术 + 力线　；参考：《实用医学杂志》2015年16期

【摘要】：目的:膝关节置换术后假体力线是取得长期疗效的关键因素,但是传统手术方法并不能取得满意的假体力线结果,本研究探讨术前胫骨力线X线定位对改善术后假体冠状位力线作用。方法:选取2012年8月至2014年8月需行单侧人工膝关节置换术患者106例,采用随机分组方法,其中术前定位组54例,传统手术组52例。术前定位组术前采用X线定位胫骨冠状力线并在皮肤上标志,术中胫骨截骨冠状位力线参照术前标志线。比较2组患者手术时间、术中出血、术后假体冠状位力线的差异以及2组患者术后力线不良的例数,并进行统计学分析。结果:2组患者手术时间以及术中出血量、术后假体股骨角,以及股骨假体力线不良率比较差异无显著性,术前定位组术后胫骨假体角以及下肢力线角均优于传统手术组(分别为91.01°vs.91.86°,P=0.01;181.48°vs.182.17°,P=0.04),术前定位组胫骨假体力线不良率以及下肢力线角不良率比传统手术组少(分别为7.4%vs.25%,P=0.01;5.6%vs.23.1%,P=0.01)。结论:术前胫骨冠状位力线X线定位不增加膝关节置换术手术时间以及术中出血量,可以有效提高术后胫骨假体以及下肢冠状位力线。
[Abstract]:Objective: pseudo manual line after knee arthroplasty is the key factor to obtain long-term curative effect, but the traditional operation method can not obtain satisfactory results of pseudo manual line. The aim of this study was to investigate the effect of preoperative X-ray localization of tibial force-ray on coronal force line of prosthesis. Methods: 106 patients who needed unilateral knee arthroplasty from August 2012 to August 2014 were randomly divided into two groups: preoperative positioning group (54 cases) and traditional operation group (52 cases). In the preoperative localization group, the tibial coronal force line was located and marked on the skin by X-ray before operation, and the coronal force line of tibial osteotomy was referred to the preoperative marker line during the operation. The time of operation, intraoperative bleeding, the difference of coronal force line of prosthesis and the number of cases of dyskinesia after operation in two groups were compared and analyzed statistically. Results there was no significant difference in operative time, blood loss during operation, femoral angle of prosthesis, and the rate of femoral pseudophysical failure in the two groups, and there was no significant difference between the two groups. Conclusion: preoperative radiographic localization of tibial coronal force line can improve tibial prosthesis and lower extremity coronal force line effectively without increasing operation time and blood loss during knee arthroplasty.
【作者单位】：广州市南方医科大学南方医院;惠州市中心人民医院;广
【基金】：国家自然科学基金青年基金(编号:81101389) 广东省自然科学基金博士启动项目(编号:s2011040003467) 惠州市科技计划项目(编号:2012y012)
【分类号】：R687.4;R816.8

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