摘要
目的评价采用3D打印截骨导板辅助全膝关节置换术治疗膝关节外骨折后遗膝关节骨性关节炎患者能否简化手术操作,并且获得与单纯膝关节骨性关节炎全膝关节置换术相同的疗效。方法观察组纳入自2017-12-2020-12采用3D打印截骨导板辅助全膝关节置换术治疗的7例膝关节外骨折后遗膝关节骨性关节炎,对照组纳入同期行全膝关节置换术治疗的14例单纯膝关节骨性关节炎。比较两组手术时间、术中出血量、术后引流量,术后12个月膝关节KSS评分较术前改善程度,以及术后12个月影像学指标(髋膝踝角、股骨远端外侧角、胫骨近端内侧角)。结果21例均获得1年以上随访。术后X线片显示所有患者均获得良好的下肢力线,残留内翻畸形在3°以内,无外翻畸形。观察组与对照组术后12个月膝关节活动范围、膝关节KSS临床评分、膝关节KSS功能评分较术前明显改善,差异有统计学意义(P<0.05)。观察组术后12个月膝关节活动范围小于对照组,差异有统计学意义(P<0.05)。观察组与对照组手术时间、术中出血量、术后引流量、术后12个月膝关节KSS评分改善程度、术后12个月影像学指标比较差异无统计学意义(P>0.05)。结论3D打印截骨导板辅助全膝关节置换术治疗膝关节外骨折后遗膝关节骨性关节炎患者能够完成详细术前规划、提高手术精准度,进而缩短手术时间,有效恢复下肢力线和膝关节功能。
Objective To evaluate whether the use of 3D printed osteotomy guide assisted total knee arthroplasty in the treatment of patients with knee osteoarthritis after extra-articular fractures can simplify the surgical operation and achieve the same curative effect as simple knee osteoarthritis total knee arthroplasty.Methods The observation group included 7 cases of knee osteoarthritis after extra-articular fractures treated with 3D printing osteotomy guide assisted total knee arthroplasty from December 2017 to December 2020,and the control group included 14 cases of simple knee osteoarthritis treated with total knee arthroplasty in the same period.The operation time,intraoperative blood loss,postoperative drainage volume,the improvement degree of knee joint KSS score at 12 months after operation,and the imaging indicators at 12 months after operation(including hip knee ankle angle,distal lateral angle of femur,proximal medial angle of tibia)were compared between the two groups.Results Twenty-one cases were followed up for more than 1 year.Postoperative X-ray films showed that all patients had good lower limb alignment,residual varus deformity within 3°,and no valgus deformity.The knee joint range of motion,knee KSS clinical score and knee KSS function score were significantly improved in the observation group and the control group 12 months after operation,and the differences were statistically significant(P<0.05).The range of motion of the knee joint in the observation group was smaller than that in the control group at 12 months after operation,and the difference was statistically significant(P<0.05).There was no significant difference in operation time,intraoperative blood loss,postoperative drainage,improvement of knee joint KSS score at 12 months after operation,and imaging indicators at 12 months after operation between the observation group and the control group(P>0.05).Conclusion 3D printing osteotomy guide assisted total knee arthroplasty in the treatment of patients with knee osteoarthritis after extra-articular fractures can complete detailed preoperative planning and improve the accuracy of surgery,thereby shortening the operation time and effectively restoring lower limb alignment as well as knee function.
作者
赵资坚
张荣臻
蔡史健
钟志刚
ZHAO Zi-jian;ZHANG Rong-zhen;CAI Shi-jian;ZHONG Zhi-gang(Department of Orthopaedics,the Second People’s Hospital of Shantou,Shantou,Guangdong 515011,China)
出处
《中国骨与关节损伤杂志》
2022年第6期580-584,共5页
Chinese Journal of Bone and Joint Injury
基金
汕头市医疗卫生科技计划项目(汕府科[2018]11号)。
