本文選題：骨性關(guān)節(jié)炎 + 膝關(guān)節(jié)單髁置換術(shù)(UKA)��； 參考：《廣州中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：牛津單髁假體系統(tǒng)作為療效可靠的單髁關(guān)節(jié)之一,在國(guó)內(nèi)已經(jīng)得到廣泛開展。本文主要探討使用牛津第三代單髁系統(tǒng)治療膝關(guān)節(jié)內(nèi)側(cè)間室骨性關(guān)節(jié)炎的患者術(shù)后下肢力線改變與近期療效。方法：回顧性分析從2014年12月至2015年12月在廣東省中醫(yī)院關(guān)節(jié)科行膝關(guān)節(jié)牛津單髁置換術(shù)治療的38例(38膝)膝關(guān)節(jié)內(nèi)側(cè)間室病變患者,其中男10例10膝,女28例28膝；平均年齡66歲(52-79歲)；平均體重66kg(48-90kg)；術(shù)后隨訪3-14月,平均8.8月。全部病例均由同一主刀完成,使用第三代牛津膝單髁假體系統(tǒng),行膝關(guān)節(jié)內(nèi)側(cè)髁置換,采取微創(chuàng)UKA小切口技術(shù)。收集統(tǒng)計(jì)患者手術(shù)時(shí)間、術(shù)中出血量、圍手術(shù)期是否輸血、術(shù)后住院時(shí)間等資料進(jìn)行療效分析；觀察有無(wú)UKA術(shù)后并發(fā)癥出現(xiàn)；手術(shù)前后均行患側(cè)膝關(guān)節(jié)正側(cè)位X線片及雙下肢全長(zhǎng)負(fù)重位X線片,分別測(cè)量術(shù)前及術(shù)后脛股角(femorotibial angle, FTA)、髖-膝-踝角度(hip-knee-ankle angle, HKA)、膝關(guān)節(jié)最大活動(dòng)度(range of motion, ROM)并評(píng)估術(shù)前及末次隨訪時(shí)膝關(guān)節(jié)的美國(guó)特種外科醫(yī)院膝關(guān)節(jié)評(píng)分(hospital for special surgery knee score,簡(jiǎn)稱HSS評(píng)分)、美國(guó)膝關(guān)節(jié)協(xié)會(huì)評(píng)分(American knee society knee score,簡(jiǎn)稱KSS評(píng)分)。采用SPSS18.0軟件對(duì)數(shù)據(jù)進(jìn)行處理和統(tǒng)計(jì)學(xué)方法分析((P0.05認(rèn)為具有統(tǒng)計(jì)學(xué)意義)。結(jié)果：38例(38膝)患者手術(shù)時(shí)間平均為：76.6(60-90)min,術(shù)中出血量：52.6m,術(shù)后住院天數(shù)平均為7.8天(7-10天),所有患者手術(shù)切口均為甲級(jí)愈合。圍手術(shù)期內(nèi),所有患者均無(wú)輸血,均無(wú)感染、肺栓塞、下肢深靜脈血栓、醫(yī)源性神經(jīng)血管損傷、假體周圍骨折等圍手術(shù)期并發(fā)癥出現(xiàn)；平均隨訪8.8月(3-14月),患者生活質(zhì)量較術(shù)前得到明顯提高,所有病例均沒(méi)有無(wú)菌性假體松動(dòng)、不明原因疼痛、聚乙烯襯墊脫位等并發(fā)癥。術(shù)前HKA為173.65±3.55°,術(shù)后為177.50±1.37°；術(shù)前FTA平均為180.01±4.16°,術(shù)后平均為175.39±5.91。；術(shù)后膝關(guān)節(jié)最大活動(dòng)度從術(shù)前的98.0±7.8°增長(zhǎng)至術(shù)后的109.7±7.9°,以上數(shù)據(jù),術(shù)前與術(shù)后相比,差異均具有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)前和末次隨訪膝關(guān)節(jié)KSS臨床評(píng)分分別為61.3±10.0和89.7±4.0；KSS功能評(píng)分分別為58.3±7.3和83.2±7.1；術(shù)前和末次隨訪時(shí)膝關(guān)節(jié)HSS評(píng)分分別為67.2±5.8和88.6±5.0,三組評(píng)分,術(shù)前和末次隨訪相比,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：研究結(jié)果表明,對(duì)于膝關(guān)節(jié)內(nèi)側(cè)間室病變的患者,利用第三代牛津單髁系統(tǒng),采用微創(chuàng)單髁技術(shù)行手術(shù)治療,具有術(shù)中創(chuàng)傷小、切除骨質(zhì)少、手術(shù)時(shí)間短、失血量少,術(shù)后住院時(shí)間短、并發(fā)癥少、術(shù)后恢復(fù)快、關(guān)節(jié)活動(dòng)度大、本體感覺(jué)好等優(yōu)勢(shì)。術(shù)后近期療效滿意,下肢力線改善明顯,其遠(yuǎn)期效果有待進(jìn)一步的觀察。
[Abstract]:Objective: Oxford single condylar prosthesis system, as one of the reliable single condylar joints, has been widely carried out in China. This paper mainly discusses the change of lower limb force line and the short term effect after the operation of the third generation single condylar system of Oxford in the treatment of the medial compartment osteoarthritis of the knee joint. A retrospective analysis from December 2014 to 1 is a retrospective analysis. In February, 38 patients (38 knees) with medial compartment lesions of the knee joint treated with Oxford single condylar replacement of the knee joint in Guangdong Province Traditional Chinese Medical Hospital, including 10 males and 10 knees, 28 women and 28 knees, mean age 66 (52-79 years) and average weight of 66kg (48-90kg), followed up for 3-14 months with an average of 8.8 months. All cases were completed by the same main knife and used third. On behalf of the Oxford knee single condylar prosthesis system, the medial condyle of the knee joint was replaced by the medial condyle of the knee joint, and the minimally invasive UKA small incision technique was adopted. The data of the operation time, the amount of bleeding in the operation, the perioperative blood transfusion, the postoperative hospital time and other data were analyzed, and the postoperative complications were observed and the X-ray films of the affected side of the knee joint were performed before and after the operation. The tibial angle (femorotibial angle, FTA), hip knee - ankle angle (hip-knee-ankle angle, HKA), the maximum activity of the knee joint (range of motion, ROM) were measured before and after the operation, and the knee joint score of the knee joint in American Special Surgery Hospital was evaluated before and at the last follow-up (hospital for). Ry knee score, referred to as HSS score), American Knee association score (American Knee Society knee score, referred to as KSS score). Using SPSS18.0 software for data processing and statistical analysis ((P0.05 think statistically). Results: 38 patients (38 knees) had an average operation time of 76.6 (60-90). The average number of days after operation was 7.8 days (7-10 days). All the patients were healed in the first stage. During the perioperative period, all the patients had no blood transfusion, no infection, pulmonary embolism, deep vein thrombosis of the lower limbs, iatrogenic neurovascular injury, periprosthetic fracture and other perioperative complications. The average follow-up was 8.8 months (3-14 months) and the quality of life of the patients. No aseptic prosthesis loosening, unexplained pain, polyethylene liner dislocation and other complications were found in all cases. The preoperative HKA was 173.65 + 3.55 degrees and 177.50 + 1.37 degrees after operation. The average FTA was 180.01 + 4.16 degrees before operation, and the average after operation was 175.39 + 5.91.. The maximum knee joint activity after operation increased from 98 + 7.8 degrees before the operation. The differences were statistically significant (P0.05) before and after operation (P0.05). The clinical scores of knee joint KSS before and at the last follow-up were 61.3 + 10 and 89.7 + 4, respectively, and KSS functional scores were 58.3 + 7.3 and 83.2 + 7.1, respectively, and the knee joint HSS scores were 67.2 + 5.8 and 88.6 + 5. respectively at the last and last follow-up. 0, three groups, the differences were statistically significant (P0.05). Conclusion: the results showed that the patients with medial compartment lesions of the knee joint were treated with third generation Oxford single condyle system and minimally invasive single condyle technique, with small trauma, less bone removal, short operation time, less blood loss, and postoperative stay. The hospital time is short, the complications are few, the postoperative recovery is fast, the joint activity is great, and the noumenon feeling is good. The short-term effect after the operation is satisfactory, the lower limb force line is improved obviously, and the long-term effect needs further observation.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R687.4

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李競(jìng);膝關(guān)節(jié)單髁置換術(shù)的護(hù)理[J];南京醫(yī)科大學(xué)學(xué)報(bào)(自然科學(xué)版);2004年05期

2 陳云蘇,Andrew A Freiberg;膝關(guān)節(jié)單髁置換術(shù)23例分析[J];中國(guó)臨床醫(yī)學(xué);2004年05期

3 陳輝;操石磊;張春禮;;膝關(guān)節(jié)單髁置換術(shù)的研究現(xiàn)狀[J];中國(guó)矯形外科雜志;2007年07期

4 郭萬(wàn)首;劉朝輝;程立明;李子榮;;小切口單髁置換術(shù)治療膝關(guān)節(jié)骨性關(guān)節(jié)炎[J];中日友好醫(yī)院學(xué)報(bào);2008年05期

5 賈俊青;紀(jì)斌平;高遠(yuǎn)朋;李淵;李春英;;膝關(guān)節(jié)單髁置換術(shù)50例分析[J];山西醫(yī)藥雜志;2009年02期

6 宋華榮;喻忠;王黎明;桂鑒超;候明夫;姚京東;徐燕;;膝關(guān)節(jié)單髁置換術(shù)治療單側(cè)脛股間隙骨關(guān)節(jié)炎的臨床研究[J];中華關(guān)節(jié)外科雜志(電子版);2010年01期

7 魏繼東;;膝關(guān)節(jié)單髁置換術(shù)22例手術(shù)效果分析[J];中國(guó)藥物與臨床;2011年06期

8 嚴(yán)廣斌;;膝關(guān)節(jié)單髁置換術(shù)[J];中華關(guān)節(jié)外科雜志(電子版);2011年06期

9 康凱;高石軍;董江濤;鄭曉佐;;膝關(guān)節(jié)單髁置換術(shù)的發(fā)展研究進(jìn)展[J];中國(guó)矯形外科雜志;2014年02期

10 蔡珉巍;劉曉東;薛華明;Q靡饣，

本文編號(hào)：2081511