本文選題：人工全膝關(guān)節(jié)置換術(shù) + 旋轉(zhuǎn)平臺　； 參考：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:分析比較旋轉(zhuǎn)平臺型假體(mobile-bearing prosthesis,MB)和固定平臺型假體(fixed-bearing prosthesis,FB)在人工全膝關(guān)節(jié)置換術(shù)(Total knee arthroplasty,TKA)術(shù)后的近期療效。比較兩種不同假體治療膝關(guān)節(jié)骨關(guān)節(jié)炎(knee osteoarthritis)在改善膝關(guān)節(jié)疼痛,糾正畸形,重建功能等方面的差異,為臨床更好的選擇假體提供依據(jù)。方法:回顧性分析比較2014年1月—2014年12月在我院診斷為晚期膝關(guān)節(jié)骨關(guān)節(jié)炎并行初次TKA的患者,共118例病例(139膝),根據(jù)選用假體不同分為:旋轉(zhuǎn)平臺組35例(40膝);固定平臺組83例(99膝)。術(shù)后進行定期門診復(fù)診或電話跟蹤,比較旋轉(zhuǎn)平臺組患者與固定平臺組患者術(shù)前及末次隨訪時的美國特種外科醫(yī)院(Hospital of Special Surgery,HSS)評分、美國膝關(guān)節(jié)學(xué)會(Knee Society Scoring System,KSS)評分和膝關(guān)節(jié)的活動度(Range of motion,ROM)以及術(shù)后影像學(xué)資料、并發(fā)癥等情況。兩組所有數(shù)據(jù)均采用SPSS19.0軟件對兩種不同類型假體在TKA術(shù)后近期的臨床療效分析對比,P0.05則認為差異具有統(tǒng)計學(xué)意義。結(jié)果:所納入研究的膝關(guān)節(jié)置換患者有28例失訪,余患者均取得了隨訪并配合完成各項評估指標(biāo),兩組患者術(shù)前的性別、年齡、病程、高血壓病、糖尿病等既往史方面均無統(tǒng)計學(xué)差異,兩種假體均未發(fā)生假體的松動、襯墊磨損或脫出等需進行翻修術(shù)的病例。影像學(xué)所見兩組患者的假體位置及力線良好,未見假體周圍透亮帶而行翻修術(shù)。到末次隨訪時:旋轉(zhuǎn)平臺組患者的HSS評分為92.9±5.8,KSS評分為91.5±4.2,ROM為118.67±21.96;固定平臺組的HSS評分為93.4±6.1,KSS評分為92.3±4.1,ROM為115.67±20.52。術(shù)后末次隨訪時兩種不同假體選擇的患者的HSS評分、KSS評分、ROM評分較術(shù)前均得到明顯的提高,具有統(tǒng)計學(xué)意義(P0.05),旋轉(zhuǎn)平臺組與固定平臺組兩者之間的術(shù)后近期療效對比差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:根據(jù)本次隨訪對比研究結(jié)果顯示:旋轉(zhuǎn)平臺型假體與固定平臺型假體治療膝關(guān)節(jié)晚期骨關(guān)節(jié)炎均可獲得良好的療效,術(shù)后近期療效無統(tǒng)計學(xué)差異。
[Abstract]:Objective: to compare the short-term effects of mobile-bearing prosthesis (Mobe-bearing) and fixed-bearing prosthesis (FBs) on total knee arthroplasty (TKAA) after total knee arthroplasty (TKA). To compare the difference of two kinds of prostheses in improving knee pain, correcting deformity and rebuilding function in knee osteoarthritis, and providing evidence for clinical choice of prosthesis. Methods: from January 2014 to December 2014, patients with advanced knee osteoarthritis and initial TKA in our hospital were retrospectively analyzed and compared. A total of 118 cases were divided into two groups according to the selection of prosthesis: rotation platform group (35 cases) and fixed platform group (83 cases). The patients in the rotating platform group and the fixed platform group were compared with those in the United States special surgery hospital of Special Surgeryn HSS scores before and after the last follow-up, the patients were followed up by regular outpatient consultation or telephone follow-up after operation, and the scores were compared between the patients in the rotating platform group and the fixed platform group. The American Society of knee Joint (AKS) score of knee Society Scoring system and the range of motion of knee joint, the imaging data and complications after operation, and so on. All the data of the two groups were analyzed by SPSS19.0 software in the short term after TKA. The results showed that the difference was statistically significant (P0.05). Results: Twenty-eight patients with knee arthroplasty were involved in the study. All the remaining patients were followed up and completed various evaluation indexes. Gender, age, course of disease, hypertension before operation in both groups. There was no statistical difference in the past history of diabetes mellitus and no loosening of prosthesis was found in the two kinds of prostheses. The position and force line of the prosthesis were good in the two groups, and no bright zone around the prosthesis was seen. At the last follow-up, the HSS score of the patients in the rotating platform group was 92.9 鹵5.8m and the HSS score in the fixed platform group was 118.67 鹵21.96.The HSS score of the fixed platform group was 92.3 鹵4.1mm and 115.67 鹵20.52 respectively. At the last follow-up, the HSS score and the ROM score of the patients with two different prosthesis choices were significantly higher than those of the patients before operation. There was no significant difference in the short-term curative effect between the rotating platform group and the fixed platform group. Conclusion: according to the results of this follow-up study, the results show that the rotary platform prosthesis and the fixed platform prosthesis can obtain good curative effect in the treatment of advanced osteoarthritis of knee joint, but there is no statistical difference in the short-term curative effect after operation.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4
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本文編號：1967086