| 人工全膝关节置换术后早期胫骨内侧疼痛的病例对照研究 |
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投稿时间：2014-01-06
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| 作者 | Author | 单位 | Address | E-Mail |
| 柴伟 |
CHAI Wei |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, General Hospital of PLA, Beijing 100853, China |
chaiwei301@gmail.com |
| 孙长鲛 |
SUN Chang-jiao |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, General Hospital of PLA, Beijing 100853, China |
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| 倪明 |
NI Ming |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, General Hospital of PLA, Beijing 100853, China |
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| 张国强 |
ZHANG Guo-qiang |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, General Hospital of PLA, Beijing 100853, China |
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| 张强 |
ZHANG Qiang |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, General Hospital of PLA, Beijing 100853, China |
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| 沈研 |
SHEN Yan |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, General Hospital of PLA, Beijing 100853, China |
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| 周勇刚 |
ZHOU Yong-gang |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, General Hospital of PLA, Beijing 100853, China |
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| 陈继营 |
CHEN Ji-ying |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, General Hospital of PLA, Beijing 100853, China |
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| 王岩 |
WANG Yan |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, General Hospital of PLA, Beijing 100853, China |
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| 期刊信息：《中国骨伤》2014年，第27卷，第4期，第269-273页 |
| DOI：10.3969/j.issn.1003-0034.2014.04.002 |
| 基金项目:国家863主题项目资助（编号：2011AA030101） |
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中文摘要:
目的：比较人工全膝关节置换术（total knee arthroplasty，TKA）采用骨膜剥离器和电刀松解内侧副韧带及鹅足后发生膝前痛的差异。
方法：2009年9月至2012年9月，选取解放军总医院行单侧初次膝关节置换的患者共220例，分为骨膜剥离器组和电刀组。骨膜剥离器组110例，男47例，女63例，平均年龄（58.8±17.2）岁，膝内翻（14.0±3.5）°，体重（65.6±12.8） kg，体重指数（body mass index，BMI）（26.6±3.6） kg/m2；电刀组110例，男49例，女61例；平均年龄（59.6±16.7）岁，膝内翻（15.0±4.7）°，体重（66.4 ±13.4） kg，BMI（27.4±4.1） kg/m2.平均随访时间24.6个月，术后评定两组患者末次随访时AKS膝评分、VAS疼痛评分和HSS评分。
结果：两组患者术后切口均Ⅰ期愈合，无下肢深静脉血栓形成及肺栓塞发生。术后3例发生感染（电刀组2例，骨膜剥离器组1例），行Ⅱ期翻修手术，使用TC3假体及抗生素骨水泥固定，随访期间未再发生感染。20例出现膝前区疼痛，其中电刀组4例，骨膜剥离器组16例，电刀组膝前区疼痛发生率低于骨膜剥离器组。末次随访时AKS膝评分和HSS评分电刀组高于骨膜剥离器组，VAS电刀组低于骨膜剥离器组。
结论：与使用骨膜剥离器松解内侧副韧带及鹅足相比，使用电刀术后膝前痛发生率降低。 |
| 【关键词】关节成形术，置换，膝 疼痛 外科手术 病例对照研究 |
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| Case-control study on earlier medial tibial pain after total knee arthroplasty |
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ABSTRACT
Objective: To compare the difference of anterior knee pain after total knee arthroplasty(TKA) between the ways using periosteal dissector and electric scalpel to release medial collateral ligament and pes anserinus.
Methods: From September 2009 to September 2012,220 patients with unilateral osteoarthritis were treated with primary TKA in hospital 301. All the patients were randomly divided into periosteal dissector group (110 cases) or electric scalpel group (110 cases). In the periosteal dissector group,there were 47 males and 63 females,with an average age of (58.8±17.2) years old; the degree of genuavarus was (14.0±3.5)°; the weight was (65.6±12.8) kg; the body mass index (BMI) was(26.6±3.6) kg/m2. In the electric scalpel group,there were 49 males and 61 females,with an average age of (59.6±16.7) years old;the degree of genuavarus was(15.0±4.7)°; the weight was(66.4±13.4) kg; the BMI was(27.4±4.1) kg/m2. The mean follow-up period was 24.6 months. The AKS,VAS and HSS were used to evaluate clinical results.
Results: All incisions healed at the first stage;no deep vein thrombosis of lower limbs or pulmonary embolism occurred. Knee infection occurred in 3 cases (1 in the periosteal dissector group and 2 in the electric scalpel group ),and the 3 patients received stage 2 total knee revision using antibiotic bone cement and TC3 prosthesis. No recurrence of infection occurred during follow-up. Among the 20 patients who had anterior knee pain,16 patients were in the periosteal dissector group and 4 patients were in the electric scalpel group. The occurrence rate of anterior knee pain in the electric scalpel group was lower than that in the periosteal dissector group. The AKS knee score and HSS score after total knee arthroplasty in the electric scalpel group were all higher than those in the periosteal dissector group,and the VAS in electric scalpel group was lower than that of periosteal dossector group.
Conclusion: Compared with using electric scalpel,using periosteal dissector used to release medial collateral ligament and pes anserinus may cause more anterior knee pain after total knee arthroplasty. |
| KEY WORDS Arthroplasty,replacement,knee Pain Surgical procedures,operative Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 柴伟,孙长鲛,倪明,张国强,张强,沈研,周勇刚,陈继营,王岩.人工全膝关节置换术后早期胫骨内侧疼痛的病例对照研究[J].中国骨伤,2014,27(4):269~273 |
| 英文格式: | CHAI Wei,SUN Chang-jiao,NI Ming,ZHANG Guo-qiang,ZHANG Qiang,SHEN Yan,ZHOU Yong-gang,CHEN Ji-ying,WANG Yan.Case-control study on earlier medial tibial pain after total knee arthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(4):269~273 |
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