| 全膝人工关节置换术中软组织紧张分类及处理 |
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投稿时间：2004-04-13
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| 作者 | Author | 单位 | Address | E-Mail |
| 张洪美 |
ZHANG Hong-mei |
中国中医研究院望京医院骨关节一科,北京100102 |
The First Department of Bone and Joint,Wangjing Hospital of China Academy of TCM |
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| 陈卫衡 |
CHEN Wei-heng |
中国中医研究院望京医院骨关节一科,北京100102 |
The First Department of Bone and Joint,Wangjing Hospital of China Academy of TCM |
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| 赵铁军 |
ZHAO Tie-jun |
中国中医研究院望京医院骨关节一科,北京100102 |
The First Department of Bone and Joint,Wangjing Hospital of China Academy of TCM |
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| 张磊 |
ZHANG Lei |
中国中医研究院望京医院骨关节一科,北京100102 |
The First Department of Bone and Joint,Wangjing Hospital of China Academy of TCM |
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| 孙钢 |
SUN Gang |
中国中医研究院望京医院骨关节一科,北京100102 |
The First Department of Bone and Joint,Wangjing Hospital of China Academy of TCM |
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| 顾力军 |
GU Li-jun |
中国中医研究院望京医院骨关节一科,北京100102 |
The First Department of Bone and Joint,Wangjing Hospital of China Academy of TCM |
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| 期刊信息：《中国骨伤》2004年，第17卷，第12期，第717-719页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的:探讨软组织松解与平衡技术在全膝人工关节置换(TKA)手术中的重要作用。
方法:回顾分析52例(84膝)TKA病例资料。根据术中常遇到膝内外翻畸形、屈曲挛缩畸形、僵直和髌股关节外侧间隔高压征等所造成的软组织紧张分类,将软组织松解与平衡归结为内外侧副韧带的平衡、后房室结构的松解、髌骨外侧支持带的松解和伸膝装置的松解等。
结果:平均随访时间152个月(3～29个月),2例(3膝)有伸展滞缺,为5°、5°、10°;膝关节活动范围由术前(68.5±9.1)°(5°～100°)提高到(108.5±17.5)°(75°～130°);股胫角为外翻(5.8±13)°(5°～7°)。HSS评分由术前(47.5±13.4)分(6～73分)提高到(81.8±10.7)分(72～100分)。并发右股深静脉血栓(DVT)1例,髌骨假体撞击征1膝,无感染、腓总神经损伤、骨化性肌炎、骨折或肺脑栓塞等并发症。
结论:软组织彻底松解与平衡是TKA手术成功的关键因素之一,可以避免过量截骨,提高TKA的临床效果。 |
| 【关键词】关节成形术,置换,膝 分类法 软组织损伤 |
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| Classification and treatment of soft tissue tension during surgery of total knee arthroplasty |
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ABSTRACT
Objective:To investigate the important role of technique of relaxing and balancing soft tissue in the surgery of total knee arthroplasty(TKA).
Methods:Fifty-two patients(84 knees)underwent TKA were studied retrospectively.According to the types of soft tissue tensions due to varus or valgus deformities,flexion contractures,stiff knees and lateral interval high pressure syndrome of patella-femur joint in surgeries of TKAs,soft tissue treatments were summed up as the balancing between medial collateral ligament(MCL) and lateral collateral ligament(LCL),the releasing of posterior structures,resecting of patellar lateral sustain ligament and relaxing of knee extension devices.
Results:Through 15.2 months(3 to 29 months)following-up,the range of motion was increased from(68.5±9.1)° to (108.5±17.5)°,HSS knee rating passing score was improved from(47.5±13.4) points to (81.8±10.7) points,the femur-tibial angle was 5°～7°(5.8±1.3)° in valgus,and the lack of full extension were 5,5 and 10 degrees in 3 knees(2 patients).There were two patients suffered from complications that one was the deep vein thrombus(DVT) in right thigh,the other was patellar prosthesis impact symptom which was solved by arthroscopy,and there was no other complications such as infection,peroneal nerve injury,myositis ossificans,fracture or embolism syndrome in this group.
Conclusion:The adequate relaxing and balancing of soft tissue is the key factor to the success of TKA.It could avoid bone overresection during the surgery of TKA and enhance the effect of TKA. |
| KEY WORDS Arthroplasty,replacement,knee Classification Soft tissue injuries |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张洪美,陈卫衡,赵铁军,张磊,孙钢,顾力军.全膝人工关节置换术中软组织紧张分类及处理[J].中国骨伤,2004,17(12):717~719 |
| 英文格式: | ZHANG Hong-mei,CHEN Wei-heng,ZHAO Tie-jun,ZHANG Lei,SUN Gang,GU Li-jun.Classification and treatment of soft tissue tension during surgery of total knee arthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2004,17(12):717~719 |
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