發(fā)布時間：2018-04-10 21:43

  本文選題：全膝關(guān)節(jié)置換術(shù) + 脛骨假體　； 參考：《福建中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：目的對比全膝關(guān)節(jié)置換術(shù)中三種脛骨假體旋轉(zhuǎn)定位的方法,尋求較為簡便、準(zhǔn)確的旋轉(zhuǎn)定位方法,以期提高全膝關(guān)節(jié)置換術(shù)后關(guān)節(jié)穩(wěn)定性、活動度及使用壽命。方法2013年3月-2014年9月,對45例膝關(guān)節(jié)骨關(guān)節(jié)炎患者行全膝關(guān)節(jié)置換術(shù)(后交叉韌帶替代型骨水泥旋轉(zhuǎn)人工膝關(guān)節(jié)),其中男17例,女28例,年齡55-80歲。以入院時間為前后順序,隨機抽取定位方法,分為3組,每組15病人。術(shù)中脛骨假體定位方法：A組采用脛骨結(jié)節(jié)中內(nèi)1/3作為參照,B組采用ROM(Range-Of-Motio n)技術(shù)作為參照,C組采用脛骨前后軸作為參照。術(shù)前、術(shù)后評估HSS評分、髕骨評分、FTA角及Q角,術(shù)中測量三組聚乙烯假體墊片的旋轉(zhuǎn)角度。計量數(shù)據(jù)以均數(shù)±標(biāo)準(zhǔn)差表示,使用SPSS17.0統(tǒng)計軟件進行統(tǒng)計學(xué)分析,單因素方差分析應(yīng)用于各組組內(nèi)對比,組間對比則采用t檢驗,p值0.05則認定為有統(tǒng)計學(xué)意義。結(jié)果ABC三組術(shù)前HSS評分(44.3±4.0 VS 44.8±4.1 VS 44.5±3.5)分,術(shù)前髕骨評分(12.9±1.9 VS 12.6±2.1 VS 11.6±2.0)分,術(shù)前脛股角(8.9±2.7°VS 9.7±3.2°VS 9.2±3.1°),術(shù)前Q角(20.6±2.7°VS 19.8±2.4°VS 19.5±2.5°)。ABC三組術(shù)后HSS評分(86.7±3.8 VS 86.8±3.5 VS 89.4±2.3)分,術(shù)后髕骨評分(19.6±2.4 VS 19.6±1.6 VS 20.9±2.6)分,術(shù)后脛股角(6.2±1.9°VS 5.7±1.6° VS 5.8±1.5°),術(shù)后Q角(15.7±1.7°VS 14.8±1.6°VS15.5±1.8°)。組內(nèi)兩兩比較無統(tǒng)計學(xué)意義(P0.05),術(shù)前與術(shù)后比較有統(tǒng)計學(xué)意義(P0.05)。A組患者聚乙烯半月板墊片平均內(nèi)旋(10.1±2.7)°。B組患者的聚乙烯半月板墊片平均內(nèi)旋(0.8±2.8)°。C組患者聚乙烯半月板墊片平均內(nèi)旋(0.65±2.6)°。A與B、A與C比較有統(tǒng)計學(xué)意義(P0.05)；B與C比較無統(tǒng)計學(xué)意義(P0.05)。結(jié)論在全膝關(guān)節(jié)置換術(shù)中,采用脛骨結(jié)節(jié)中內(nèi)1/3為定位方法時,與股骨假體的位置相比較,其出現(xiàn)脛骨假體過度外旋機會較大；當(dāng)使用ROM方法時,若股骨假體位置準(zhǔn)確且能夠充分地行軟組織松解,其能夠獲得較好的對線對位；考慮到術(shù)中定位的準(zhǔn)確性及直觀性,以脛骨前后軸軸作為脛骨假體的定位參照時,兩側(cè)假體之間能夠獲得較為準(zhǔn)確的對位。
[Abstract]:Objective to compare the three rotation localization methods of tibial prosthesis in total knee arthroplasty (TKA), and to find a simple and accurate method to improve the stability, range of motion and service life of tibial prosthesis after total knee arthroplasty (TKR).Methods from March 2013 to September 2014, 45 patients with knee osteoarthritis underwent total knee arthroplasty (posterior cruciate ligament replacement bone cement rotation artificial knee arthroplasty), including 17 males and 28 females aged from 55 to 80 years.According to the time of admission before and after, the method was randomly selected and divided into 3 groups, 15 patients in each group.Intraoperative tibial prosthesis localization method: group A used 1 / 3 of tibial nodule as reference group, group B used ROM(Range-Of-Motio nn technique as reference group, group C used tibial anterior and posterior axis as reference.Before and after operation, the HSS score, patella score, and Q angle were evaluated, and the rotation angle of polyethylene prosthesis gasket was measured during operation.The measurement data were expressed as mean 鹵standard deviation and were statistically analyzed by SPSS17.0 software. The single factor variance analysis was applied to the intra-group contrast and the inter-group contrast was determined to be statistically significant by using t test (0.05).緇撴灉ABC涓夌粍鏈墠HSS璇勫垎(44.3鹵4.0 VS 44.8鹵4.1 VS 44.5鹵3.5)鍒，

本文編號：1733040