本文選題：膝關(guān)節(jié)翻修術(shù) + 關(guān)節(jié)線�。� 參考：《山東醫(yī)藥》2017年16期

【摘要】：目的探討膝關(guān)節(jié)翻修術(shù)后關(guān)節(jié)線變化對膝關(guān)節(jié)功能的影響。方法選擇擬行膝關(guān)節(jié)翻修術(shù)患者89例(共89膝),均植入LCCK髁限制性膝關(guān)節(jié)假體進(jìn)行膝關(guān)節(jié)翻修術(shù)。術(shù)前及術(shù)后24個(gè)月,根據(jù)X線平片檢查結(jié)果測量關(guān)節(jié)線,比較關(guān)節(jié)線變化≤2 mm、2~≤4 mm、4 mm者手術(shù)前后膝關(guān)節(jié)評分、功能評分、Feller髕骨評分及膝關(guān)節(jié)活動(dòng)度。比較術(shù)中應(yīng)用或未應(yīng)用脛骨、股骨金屬填充塊者的關(guān)節(jié)線變化及上述膝關(guān)節(jié)功能相關(guān)指標(biāo)。結(jié)果患者術(shù)后關(guān)節(jié)線變化為-4.1~8.9 mm,上移70例、下移19例;關(guān)節(jié)線變化≤2 mm 23例,2~≤4 mm 35例,4 mm 31例。與術(shù)前比較,相同關(guān)節(jié)線變化者術(shù)后膝關(guān)節(jié)評分、功能評分、Feller髕骨評分及膝關(guān)節(jié)活動(dòng)度均升高(P均0.01);但關(guān)節(jié)線變化≤2 mm及2~≤4 mm者術(shù)后膝關(guān)節(jié)評分、功能評分、Feller髕骨評分均高于關(guān)節(jié)線變化4mm者(P均0.01)。術(shù)中應(yīng)用股骨金屬填充塊40例、未應(yīng)用49例,其術(shù)后關(guān)節(jié)線變化分別為-4.1~7.9(1.9±3.4)、2.2~8.9(3.5±3.4)mm,二者比較P0.05。術(shù)中應(yīng)用脛骨金屬填充塊14例、未應(yīng)用75例,二者術(shù)后關(guān)節(jié)線變化比較P0.05。應(yīng)用股骨金屬填充塊者術(shù)后功能評分、Feller髕骨評分均高于未應(yīng)用者(P0.05或0.01),應(yīng)用與未應(yīng)用脛骨金屬填充塊者術(shù)后膝關(guān)節(jié)評分、功能評分、Feller髕骨評分、膝關(guān)節(jié)活動(dòng)度比較差異均無統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論膝關(guān)節(jié)翻修術(shù)后關(guān)節(jié)線變化4 mm的患者膝關(guān)節(jié)功能較差,術(shù)中應(yīng)用股骨金屬填充塊有利于減小關(guān)節(jié)線變化及提高膝關(guān)節(jié)功能,而脛骨金屬填充塊則無明顯作用。
[Abstract]:Objective to investigate the effect of the change of the joint line on the function of the knee joint after the knee arthroplasty. Methods 89 patients (89 knees) were selected for the knee arthroplasty (total 89 knees), and the LCCK condyle prosthesis was implanted into the knee arthroplasty. The joint lines were measured before and 24 months after the operation, and the changes of the joint line were less than 2 mm, 2~ 4 mm, 4 mm before and after operation knee joint score, function score, Feller patellar score and knee joint activity. Compare the changes of the joint line of the tibia and the femoral metal filling block in the operation and the related indexes of the above knee joint function. Results the joint line changes after the operation were -4.1~8.9 mm, 70 cases were moved up, 19 cases were moved down and the joint line changes were changed. < 2 mm > 23 cases, 2~ < 4 mm 35 cases, 4 mm 31 cases. Compared with pre operation, the knee joint score, function score, Feller patellar score and knee joint activity increased (P 0.01), but the knee joint line changes less than 2 mm and 2~ < 4 mm, the function score, and the Feller patellar score were higher than those of the 4mm on the joint line. P 0.01). 40 cases of femoral metal filling block were used during the operation, and 49 cases were not used. The postoperative joint line changes were -4.1~7.9 (1.9 + 3.4) and 2.2~8.9 (3.5 + 3.4) mm respectively. Two were compared with 14 cases of tibial metal filling block in P0.05. operation, 75 cases were not used. The postoperative functional score of femoral metal filling block in P0.05. application was compared with P0.05. after operation, Fel The ler patellar scores were all higher than those of those who were not used (P0.05 or 0.01). There was no significant difference in knee joint score, functional score, Feller patellar score and knee joint activity (P 0.05). Conclusion the knee joint function of patients with 4 mm after knee arthroplasty was poor, and the operation was applied during the operation. The metal filling block of femur is beneficial to reduce the change of the joint line and improve the function of the knee joint, while the tibial metal filling block has no obvious effect.

【作者單位】： 北京積水潭醫(yī)院;
【基金】：國家自然科學(xué)基金資助項(xiàng)目(81472139)
【分類號】：R687.4

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