王传宝 郜玉忠 王中元 崔宇腾 邹智
[摘要] 目的 探討全膝关节置换术中股骨前髁截骨量与股骨前髁侧假体的差异对术后膝关节活动度的影响。 方法 收集2018年6月至2019年9月在锦州医科大学附属第一医院住院行全膝关节置换术的膝关节骨性关节炎患者共计62例。术中测量股骨前髁截骨骨块最高处和所用锯片的厚度,定义T=股骨前髁截骨骨块最高处厚度+锯片厚度,根据T将患者分为A(T<8 mm)14例、B(8 mm≤T≤10 mm)32例、C(T>10 mm)16例三组,收集三组患者手术前后HSS评分、Melbourne髌股关节评分、ROM、膝关节正侧位资料并进行统计学分析。 结果 62例患者得到良好的随访,随访时间12个月。三组患者术后HSS评分、Melbourne髌股关节评分、ROM均优于术前,差异有统计学意义(P<0.05),而术前与术后的HSS、ROM的组间差异并无统计学意义(P>0.05)。A组与B、C组的术后Melbourne评分差异有统计学意义(P<0.05),B、C组间的术后Melbourne评分差异没有统计学意义(P>0.05)。 结论 全膝关节置换术能够改善终末期膝关节骨性关节炎患者的功能障碍、提高生活质量。术中股骨前髁截骨量与假体前髁厚度之间的差异对膝关节活动度无临床意义,对髌股关节功能有统计学意义影响。
[关键词] 全膝关节置换术;膝关节骨性关节炎;髌股关节;活动度
[中图分类号] R687.4 [文献标识码] B [文章编号] 1673-9701(2021)24-0090-04
Effect of osteotomy of anterior femoral condyle on range of motion of knee joint after total knee arthroplasty
WANG Chuanbao1, 2 GAO Yuzhong2 WANG Zhongyuan1, 2 CUI Yuteng1, 2 ZOU Zhi1, 2
1.Jinzhou Medical University,Jinzhou 121000,China;2.Department of Joint Surgery of the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000,China
[Abstract] Objective To investigate the effect of of the difference between the volume of the intraoperatively removed anterior femoral condyle and prosthetic anterior femoral condyle on the range of motion of knee joint after total knee arthroplasty. Methods A total of 62 patients with knee osteoarthritis who underwent total knee arthroplasty in the department of joint surgery of the first affiliated Hospital of JinZhou Medical University from June 2018 to September 2019 were collected. The highest depth of the removed femoral anterior condyle and the thickness of sawblade used were measured intraoperatively, and T was defined as the highest depth of the removed femoral anterior condyle+sawblade thickness.Based on the T values, the patients were divided into three groups: A (T<8 mm) Fourteen patients, B (8 mm≤T≤10 mm)thirty-two patients, C (T>10 mm) sixteen patients.The HSS scores、Melbourne scores、X-ray of the Knee and rang of motion were evaluated preoperative and postoperative,and the data for statistical analysis. Results A total of 62 patients were followed up well;with an average follow-up 12 months.The follow-up results show statistically significant differences were found in the HSS scores、Melbourne scores and rang of motion of postoperative were better than preoperative in the three groups(P<0.05), and the HSS scores、Melbourne scores and rang of motion among the three groups show no statistically significant differences before and after the surgeries(P>0.05). The Melbourne scores of the patellofemoral joints after the surgeries in group B and C were statistically different from those in group A(P<0.05) and no statistically different between group B and C. Conclusion Total knee arthroplasty can improve the knee dysfunction and quality of life of patients with knee osteoarthritis. The volumes of intraoperatively removed anterior femoral condyle and the thickness of prosthetic anterior condyle present no statistical effects on knee joint mobility,but have statistically significant effects on the functions of the patellofemoral joint.