【摘要】：[目的]探究膝關(guān)節(jié)單髁置換術(shù)脛骨假體精準(zhǔn)定位的方法及其對(duì)臨床療效的影響。[方法]2014年6月~2014年12月,116例膝關(guān)節(jié)內(nèi)側(cè)間室骨性關(guān)節(jié)炎患者,隨機(jī)分成兩組進(jìn)行單髁置換術(shù),術(shù)前定位組60膝,傳統(tǒng)手術(shù)組56膝。術(shù)前定位組采用術(shù)前定位方法,即調(diào)整脛骨截骨導(dǎo)向器桿冠狀面與脛骨嵴平行、矢狀面遠(yuǎn)端距離皮膚1.80cm進(jìn)行脛骨平臺(tái)截骨;傳統(tǒng)手術(shù)組采用牛津MP操作手冊(cè)推薦的方法,即脛骨導(dǎo)向器在兩個(gè)平面上均與脛骨長(zhǎng)軸平行進(jìn)行脛骨平臺(tái)截骨。測(cè)量比較兩組患者術(shù)后脛骨假體內(nèi)外翻角(TCVA),脛骨假體后傾角(TCPSA)及HSS評(píng)分。[結(jié)果]術(shù)后平均隨訪12個(gè)月,術(shù)前定位組和傳統(tǒng)手術(shù)組術(shù)后的脛骨假體內(nèi)外翻角度分別為(0.92±1.81)°和(1.61±2.51)°(t=-1.072,P=0.288),脛骨假體后傾角度分別為(6.91±0.85)°和(7.32±1.73)°(t=-1.081,P=0.284),兩組之間差異均無(wú)統(tǒng)計(jì)學(xué)意義,但術(shù)前定位組的脛骨假體內(nèi)外翻角及后傾角更接近0°和7°,并且離散度小,更加精準(zhǔn)。兩組間術(shù)前、術(shù)后2周、6個(gè)月和1年的HSS評(píng)分差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。[結(jié)論]:本研究采用的術(shù)前定位方法能提高單髁置換術(shù)脛骨假體定位精確性,并取得了滿意的臨床效果。
[Abstract]:Objective: to investigate the accurate localization of tibial prosthesis in single condyle replacement of knee joint and its influence on clinical efficacy. [methods] from June 2014 to December 2014, 116 patients with medial compartment osteoarthritis of the knee joint were randomly divided into two groups, 60 knees in the preoperative localization group and 56 knees in the traditional operation group. In the preoperative localization group, the tibial plateau osteotomy was performed by adjusting the coronal plane of the tibial osteotomy guide bar parallel to the tibial crest and distance from the distal side of the sagittal plane to the skin 1.80cm. In other words, tibial plateau osteotomy is performed by tibial guiding device parallel to the long axis of tibia in both planes. The posterior tilt angle (TCPSA) and HSS score of tibial prosthesis (TCVA), were measured and compared between the two groups. [results] the mean postoperative follow-up was 12 months. The tibial prosthesis extraversion angles were (0.92 鹵1.81) 擄and (1.61 鹵2.51) 擄(t _ (-1.072) P _ (0.288) in the preoperative localization group and (7.32 鹵1.73) 擄(t ~ (-1.081) P _ (0.284) 擄in the traditional operation group, respectively. The tibial prosthesis retroversion angle was (6.91 鹵0.85) 擄and (7.32 鹵1.73) 擄(t ~ (-1.081) P ~ (0.284), respectively. There was no significant difference between the two groups. However, the tibial prosthesis in the preoperative positioning group was closer to 0 擄and 7 擄, and the dispersion was smaller and more accurate. There was no significant difference in HSS score between the two groups before operation, 2 weeks, 6 months and 1 year after operation (P0.05). Conclusion: the preoperative localization method used in this study can improve the accuracy of tibial prosthesis localization after monondylar replacement, and obtain satisfactory clinical results.
【作者單位】： 上海同濟(jì)大學(xué)附屬楊浦醫(yī)院;
【基金】：上海市衛(wèi)生局重大科研項(xiàng)目(編號(hào):2013040) 上海市科委引導(dǎo)類項(xiàng)目(編號(hào):13411961400)
【分類號(hào)】：R687.4

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