摘要
[目的]探讨经小切口股内侧肌入路行TKA的优点并与传统髌旁内侧入路的疗效进行比较。[方法]自2002年5月～2006年5月共收治行TKA56例60膝,其中采用小切口股内侧肌入路和传统髌旁内侧入路各28例30膝。分别对术后切口长度、疼痛度、引流出血量、手术前后Hb减少量、直腿抬高时间、术后住院天数、假体力线对位、术后6、12周、1年的活动度(ROM)及术后1年HSS评分进行比较分析。[结果]56例患者均获得随访,随访1～1.5年(平均13.2个月)。两组除各有1例胫骨假体对位不良外,其余均获得准确的力线对位。微创组,平均切口11.3cm,VAS评分平均2.76分,平均引流出血量96.8ml、术后Hb平均减少25.5g,直腿抬高平均3.8d,术后平均住院8.6d,术后6、12周的ROM分别为107°、117°;传统组,平均切口20.6cm,VAS评分平均3.8分,平均引流出血量276.3ml、术后Hb平均减少32.5g,直腿抬高平均5.8d,术后平均住院12.1d,术后6、12周的ROM分别为98°、108°。以上各观察指标的手术疗效比较,经统计学分析显示差异有显著性意义(P<0.01)。微创组术后1年的ROM及HSS评分为121°和95分相对于传统组的118°和94分差异无显著性意义(P>0.05)。[结论]经微创中股入路行全膝置换术,术后膝关节功能恢复快,早期疗效满意。
[ Objective] To compare clinical results of the mini midvastus approach with the traditional medial parapatellar approach for totall knee arthroplasty and to evaluate their advantages. [Methods] Sixty total knee arthroplasty （56 patients ） have been freated during May 2002 to May 2006, 28 patients （30 knee） were underwent TKA using either mini midvastus approach or traditional medial parapatellar approach. Two groups were compared according to skin incision length , postoperative pain score , total amount of drains , postoperative amount of decreasing Hb, active straight - leg raise time, postoperative length of stay , radiographic alignment of all the components, postoperative range of motion at 6 weeks and 12 weeks and 1 year, postoperative HSS score at 1 year. [ Results] All the patients were followed from 1 to 1.5 year （mean, 13.2 months） . Position of all the components was normal in all patients except one case with abnormal position of tibial prosthesis in both groups. In the MIS group, the average skin incision length was 11.3 cm, average visual analog pain scale was 2. 76 score, while the control group was 20.6 cm and 3.8 score. In the MIS group, the total amount of drains was 96. 8 ml, postoperative amount of decreasing Hb was 22. 5 g, while the control group was 276. 3 ml and 32. 5 g. In the MIS group, active straight - leg raise time was 3.8 days, postoperative length of stay was 8. 6 days, while the control group was 5.8 days and 12. 1 days. In the MIS group, the mean ROM at 6 weeks postoperatively was 107°and 117°at 12 weeks, while the control group was 98°and 108°. The differences between each factor group and operative results were significant （P 〈0. 01 ）. In the MIS group, the mean ROM atlyear postoperatively was 121°, HSS score at 1 year was 95 score, while the control group was 118°and 94 score. There was no significant difference （ P 〉0. 05 ）. [ Conclusion] The mini midvastus approach wis associated with a more rapid functional recovery and a more satisfactory short-term result.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2008年第7期488-491,共4页
Orthopedic Journal of China
关键词
全膝置换
膝关节
小切口股内侧肌入路
totall knee arthroplasty
knee joint
mini midvastus approach
