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全膝关节置换术关节后方复合松解中期随访的病例对照研究
Hits: 2006   Download times: 1180   Received:June 16, 2015    
作者Author单位UnitE-Mail
戴繁林 DAI Fan-lin 湖北医药学院附属东风总医院骨关节外科, 湖北 十堰 442000 Department of Bone and Joint Surgery, Dongfeng Affiliated Hospital of Hubei Medicine College, Shiyan 442000, Hubei, China  
张鹏 ZHANG Peng 湖北医药学院附属东风总医院骨关节外科, 湖北 十堰 442000 Department of Bone and Joint Surgery, Dongfeng Affiliated Hospital of Hubei Medicine College, Shiyan 442000, Hubei, China zp466624@sina.com 
田大为 TIAN Da-wei 湖北医药学院附属东风总医院骨关节外科, 湖北 十堰 442000 Department of Bone and Joint Surgery, Dongfeng Affiliated Hospital of Hubei Medicine College, Shiyan 442000, Hubei, China  
王小武 WANG Xiao-wu 湖北医药学院附属东风总医院骨关节外科, 湖北 十堰 442000 Department of Bone and Joint Surgery, Dongfeng Affiliated Hospital of Hubei Medicine College, Shiyan 442000, Hubei, China  
李刚 LI Gang 湖北医药学院附属东风总医院骨关节外科, 湖北 十堰 442000 Department of Bone and Joint Surgery, Dongfeng Affiliated Hospital of Hubei Medicine College, Shiyan 442000, Hubei, China  
周琦 ZHOU Qi 上海长征医院关节外科中心, 上海 200003  
吴海山 WU Hai-shan. 上海长征医院关节外科中心, 上海 200003  
期刊信息:《中国骨伤》2015年28卷,第10期,第888-892页
DOI:10.3969/j.issn.1003-0034.2015.10.003


目的:评价全膝关节置换术中关节后方复合松解对膝关节功能中期随访的效果。

方法:观察2010年3月至2012年3月行单侧全膝关节置换的膝关节骨性关节炎患者,分为两组:试验组和对照组,各60例。其中试验组男21例,女39例,平均年龄(62.2±10.9)岁;对照组男25例,女35例,平均年龄(64.9±11.4)岁。均取膝关节前方正中切口,术中在截骨完成后,试验组进行关节后方复合松解,包括后髁的修饰性截骨和后关节囊的贴骨松解以及必要的增生物清理,释放后方空间;对照组仅行常规的后髁增生骨的清理。安装的假体均采用同品牌后稳定型假体。通过门诊回访,对比两组术后中期随访时美国膝关节协会 (American Knee Society Score,KSS)评分情况,包含膝关节膝关节功能评分及临床评分,对比膝关节活动度。

结果:术后门诊中期随访(中位随访时间46个月),排除失访或无效患者,最终试验组49例,对照组54例获随访。膝关节KSS功能评分:试验组91.3±3.4,优于对照组86.4±3.9;而KSS临床评分试验组86.9±4.6,与对照组85.7±5.1比较差异无统计学意义。主动屈膝活动度:试验组(133.2±5.9)°,优于对照组(126.9±7.4)°主动伸膝活动度试验组(0.5±1.1)°,与对照组(0.3±1.2)°比较差异无统计学意义。

结论:膝关节后方复合松解改善膝关节功能和屈曲活动度中期效果显着,患者获益。
[关键词]:骨关节炎,膝  关节成形术,置换,膝  膝关节  病例对照研究
 
Case-control study on midterm follow-up effects of the extended release of posterior clearance in total knee arthroplasty
Abstract:

Objective:To evaluate the midterm follow-up results of extended release of posterior clearance in total knee arthroplasty.

Methods:A total of 120 patients with knee osteoarthritis were equally randomly assigned to the experimental group and control group,and underwent unilateral TKA from March 2010 to March 2012. In experimental group,there were 21 males and 39 females with an average age of (62.2±10.9) years old. In the control group,there were 25 males and 35 females with an average age of(64.9±11.4) years old. All the patients were performed using the anterior knee approach. During operation,after osteotomy of the tibia and the femoral condyle,extended release of the posterior knee clearance were taken in experimental group,while only the clearance of osteophyte in the posterior condyle were performed in the control group. The KSS scores including knee functional score and knee clinical score,as well as the range of motion(ROM) of patients,were compared between the two groups at midterm follow-up.

Results:Totally 49 patients in the experimental group and 54 patients in the control group were followed up,and the median follow-up time was 46 months. The knee functional score of patients in the experimental group was 91.3±3.4,which was better than 86.4±3.9 of patients in the control group;initiative ROM of flexion of patients in the experimental group was (133.2±5.9) °,which was better than(126.9±7.4)°of patients in the control group. There were no significant difference of knee clinical score between 86.9±4.6 of patients in the experimental group and 85.7±5.1 of patients in the control group,and the initiative ROM of extension between (0.5±1.1) °and (0.3±1.2)°。

Conclusion:Extended release of the posterior knee clearance contributes to the knee function and initiative flexion ROM during a midterm follow-up and patients benefit.
KEYWORDS:Osteoarthritis, knee  Arthroplasty, replacement, knee  Knee joint  Case-control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:戴繁林,张鹏,田大为,王小武,李刚,周琦,吴海山.全膝关节置换术关节后方复合松解中期随访的病例对照研究[J].中国骨伤,2015,28(10):888~892
英文格式:DAI Fan-lin,ZHANG Peng,TIAN Da-wei,WANG Xiao-wu,LI Gang,ZHOU Qi,WU Hai-shan..Case-control study on midterm follow-up effects of the extended release of posterior clearance in total knee arthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(10):888~892
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