| 改良型胫骨髓外定位技术应用于Link-Sled假体膝单髁关节置换术的临床疗效 |
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投稿时间：2023-12-08
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| 期刊信息：《中国骨伤》2024年，第37卷，第11期，第1120-1125页 |
| DOI：10.12200/j.issn.1003-0034.20230346 |
| 基金项目:杭州市医药卫生科技项目(编号:B20220119) |
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中文摘要:
目的: 探讨改良型胫骨髓外定位技术应用于膝单髁关节置换术(unicompartmental knee arthroplasty,UKA)治疗单间室骨性关节炎患者的临床疗效。
方法: 回顾性分析2018年5月至2022年2月,采用改良型胫骨髓外定位技术UKA治疗的75例膝关节单间室骨性关节炎患者,男33例,女42例;年龄52~73(64.0±6.0)岁;病程0.5~11.0(3.2±2.7)年;左侧31例,右侧37例,双侧手术7例。采用膝关节正侧位X线片评价假体位置,观察其术后并发症情况。比较术前和术后1年疼痛视觉模拟评分(visual analog scale,VAS)、美国特种外科医院膝关节功能(Hospital for Special Surgery,HSS)评分。术后1年采用遗忘关节评分(forgotten joint score,FJS)评价患者的遗忘程度。
结果: 75例患者获得随访,时间12~15(13.0±1.5)个月。2例术后发生并发症,其中1例为切口浅表感染,换药后愈合;1例术后1个月出现关节腔内出血,予关节镜清理手术后好转。VAS由术前的(6.4±0.9)分降低至术后1年的(2.3±0.3)分(P<0.01),HSS评分由术前的(65.2±7.5)分提高至术后1年的(92.8±5.3)分(P<0.01)。FJS术后1年为(70.5±2.3)分,表示患者对手术后膝关节的感觉接近本体感觉。
结论: UKA对于单间室骨性关节炎具有确切的临床疗效,可减轻术后疼痛,提高膝关节功能,是治疗单间室骨关节炎的主要手术方式。运用改良型胫骨髓外定位技术可以在术中更加方便、准确地定位截骨方向及假体位置,并取得良好的临床疗效。 |
| 【关键词】膝单髁关节置换术 手术技术 临床疗效 |
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| Application of modified tibial extramedullary localization technique in Link—Sled prosthesis for unicompartmental knee arthroplasty and its clinical efficacy |
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ABSTRACT
Objective To explore clinical effect of modified tibial extramedullary localization technique applied to unicompartmental knee arthroplasty(UKA) in patients with single compartment osteoarthritis.
Methods From May 2018 to February 2022,75 patients with single-compartment osteoarthritis of knee joint (33 males and 42 females) were treated with modified tibial extramedullary localization technique UKA,aged from 52 to 73 years old with an average of (64.0±6.0) years old;the course of disease ranged from 0.5 to 11.0 years with an average of (3.2±2.7) years;31 patients on the left side,37 patients on the right side and 7 patients on both sides. The position of prosthesis was evaluated by AP and lateral X-ray of knee joint and postoperative complications were observed. Visual analog scale(VAS) and Hospital for Special Surgery(HSS) of knee score were compared before and 1 year after operation. Forgotten joint score(FJS) was used to evaluate degree of amnesia at 1 year after operation.
Results Seventy-five patients were followed up for 12 to 15 months with an average of (13.0±1.5) months. Postoperative complications were occurred in 2 patients,of which 1 patient was superficial incision infection,which healed after dressing change. One patient was developed intraarticular bleeding at 1 month after operation,which was improved after arthroscopic cleaning. VAS was decreased from (6.4±0.9) before operation to (2.3±0.3) at 1 year after operation (P<0.01),and HSS was increased from (65.2±7.5) before operation to (92.8±5.3) at 1 year after operation (P<0.01). FJS score at 1 year after operation was (70.5±2.3),indicating that the sensation of knee joint after operation was close to proprioception.
Conclusion UKA has definite clinical effect on single-compartment osteoarthritis,which could reduce postoperative pain,improve knee joint function,and is the main surgical treatment for single-compartment osteoarthritis. The modified tibial extramedullary localization technique could be used to locate osteotomy direction and prosthesis position more conveniently and accurately during operation,and obtain good clinical effect. |
| KEY WORDS Unicompartment knee arthroplasty Surgical techniques Clinical efficacy |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 胡天野,林道超.改良型胫骨髓外定位技术应用于Link-Sled假体膝单髁关节置换术的临床疗效[J].中国骨伤,2024,37(11):1120~1125 |
| 英文格式: | HU Tian-ye,LIN Dao-chao.Application of modified tibial extramedullary localization technique in Link—Sled prosthesis for unicompartmental knee arthroplasty and its clinical efficacy[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(11):1120~1125 |
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