【摘要】：目的通過與固定平臺假體比較,探討采用UC旋轉(zhuǎn)平臺假體行人工全膝關(guān)節(jié)置換(total knee arthroplasty,TKA)治療膝關(guān)節(jié)骨關(guān)節(jié)炎的療效。方法回顧分析2011年1月-2012年12月因膝關(guān)節(jié)骨關(guān)節(jié)炎行TKA的98例(98膝)患者臨床資料,其中56例采用UC高型合度型旋轉(zhuǎn)平臺假體(旋轉(zhuǎn)平臺組),42例采用Gemini PS后穩(wěn)定型固定平臺假體(固定平臺組)。兩組患者性別、年齡、患膝關(guān)節(jié)側(cè)別、體質(zhì)量、病程、骨關(guān)節(jié)炎分級、內(nèi)外翻畸形例數(shù)及術(shù)前膝關(guān)節(jié)活動度、膝關(guān)節(jié)學(xué)會評分系統(tǒng)(KSS)評分、疼痛視覺模擬評分(VAS)、股脛角、脛骨角、膝關(guān)節(jié)面夾角比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。比較兩組手術(shù)時間(包括麻醉時間)、術(shù)中失血量、住院時間、住院費(fèi)用以及術(shù)后膝關(guān)節(jié)活動度、KSS評分及VAS評分。攝膝關(guān)節(jié)正側(cè)位X線片,測量股脛角、脛骨角、膝關(guān)節(jié)面夾角,觀察假體有無松動。結(jié)果兩組手術(shù)時間、術(shù)中失血量及住院時間比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05);但固定平臺組住院費(fèi)用顯著低于旋轉(zhuǎn)平臺組(t=8.506,P=0.000)。兩組患者均獲隨訪,旋轉(zhuǎn)平臺組隨訪時間為16~30個月,固定平臺組為16~38個月。術(shù)后固定平臺組3例(7.14%)發(fā)生并發(fā)癥,包括切口脂肪液化、關(guān)節(jié)僵硬、膝前區(qū)疼痛各1例;旋轉(zhuǎn)平臺組3例(5.36%)發(fā)生并發(fā)癥,包括切口延遲愈合1例、膝前區(qū)疼痛2例;兩組并發(fā)癥發(fā)生率比較差異無統(tǒng)計(jì)學(xué)意義(χ2=0.133,P=0.516)。末次隨訪時,兩組KSS評分、VAS評分、膝關(guān)節(jié)活動度以及股脛角、脛骨角、膝關(guān)節(jié)面夾角均顯著優(yōu)于術(shù)前(P0.05),但兩組間比較差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。X線片復(fù)查示,兩組無透亮線及襯墊脫位征象,未發(fā)現(xiàn)髕骨脫位、假體松動及骨折。結(jié)論采用UC旋轉(zhuǎn)平臺假體行TKA治療膝關(guān)節(jié)骨關(guān)節(jié)炎,膝關(guān)節(jié)功能獲得有效改善,疼痛緩解明顯,療效與固定平臺假體置換相似。
[Abstract]:Objective to evaluate the effect of total knee arthroplasty (total knee arthroplasty,TKA) with UC rotating platform prosthesis in the treatment of knee osteoarthritis. Methods the clinical data of 98 patients (98 knees) with TKA due to osteoarthritis of knee joint from January 2011 to December 2012 were analyzed retrospectively. among them, 56 patients were treated with UC high degree rotating platform prosthesis (rotating platform group) and 42 patients were treated with Gemini PS post stable fixed platform prosthesis (fixed platform group). There was no significant difference between the two groups in sex, age, side difference of knee joint, body mass, course of disease, grade of osteoarthritis, number of cases of varus deformity and range of motion of knee joint before operation, (KSS) score of knee joint learning system, (VAS), angle of thigh tibia, angle of tibia and angle of knee joint surface (P 0.05). The operation time (including anesthesia time), intraoperative blood loss, hospitalization time, hospitalization expenses, postoperative knee motion, KSS score and VAS score were compared between the two groups. The angle of thigh tibia angle, tibia angle and knee joint surface were measured by X-ray film of knee joint, and the loosening of the prosthesis was observed. Results there was no significant difference in operation time, blood loss and hospitalization time between the two groups (P 0.05), but the hospitalization cost in the fixed platform group was significantly lower than that in the rotating platform group (t 鈮，

本文編號：2507152