摘要
目的分析改良间隙平衡技术对全膝关节置换术(TKA)患者膝关节稳定性及膝关节功能的影响。方法我院行TKA治疗的96例患者,术中行测量截骨技术45例(常规组),行改良间隙平衡技术51例(改良组)。记录两组手术相关指标,比较两组术前及术后6月时下肢力线夹角、膝关节活动度、冠状面髋-膝-踝角(HKA)及内外侧伸膝应力位、屈膝90°应力位间隙角度、膝关节功能,评估两组术后6月并发症发生情况。结果与常规组比较,改良组股骨远端截骨量更高(P<0.05),但两组手术时间、胫骨外侧平台截骨量及术后并发症总发生率比较,差异无统计学意义(P>0.05)。与术前比较,两组术后6月下肢力线夹角、冠状面HKA、内外侧伸膝应力位及屈膝90°应力位间隙角度均缩小,且改良组术后内外侧屈膝90°应力位间隙角度较常规组更小(P<0.05);两组术后6月膝关节活动度、临床及功能评分均升高,且改良组术后膝关节功能评分较常规组更高(P<0.05),但两组术后其他指标比较,差异无统计学意义(P>0.05)。结论改良间隙平衡技术可有效修正TKA患者下肢力线,保证膝关节稳定性,并改善其膝关节功能,其截骨量虽大于测量截骨技术,但安全性表现较佳,对患者术后恢复更有利。
Objective To analyze the effects of modified gap balancing technique on knee joint stability and function in patients undergoing total knee arthroplasty(TKA).Methods Clinical data of 96 patients who underwent TKA in our hospital were collected.The patients included 45 cases adopting measurement osteotomy technique(routine group)and 51 cases undergoing modified gap balancing technique(modified group).The surgery-related indicators were recorded in the two groups.The angle of lower limb alignment,knee joint range of motion,coronal hip-knee-ankle angle(HKA),gap angles of medial and lateral knee extension stress positions and knee flexion 90°stress positions and knee joint function were compared before and after 6 months of surgery.The occurrence of complications in the two groups was evaluated after 6 months of surgery.Results Compared with the routine group,the distal femoral osteotomy volume was higher in the modified group(P<0.05).However,there were no statistical differences in the surgical time,osteotomy volume of lateral tibial plateau and total incidence rate of complications between the two groups(P>0.05).Compared with before surgery,the angle of lower limb alignment,coronal HKA and gap angles of medial and lateral knee extension stress positions and knee flexion 90°stress positions were significantly reduced after 6 months of surgery in both groups(P<0.05).The gap angles of medial and lateral knee flexion 90°stress positions were lower in the modified group than those in the routine group(P<0.05).The knee joint range of motion,clinical score and functional activity score after 6 months of surgery were significantly enlarged or enhanced in both groups(P<0.05),and the Knee Society Score(KSS)in the modified group after surgery was higher than that in the routine group(P<0.05).There was no statistical significance in other postoperative indicators between the two groups(P>0.05).Conclusion Modified gap balancing technique can effectively correct the lower limb alignment of patients undergoing TKA,ensure the stability of knee joint,and improve the knee joint function.Although its osteotomy volume is greater than that of measurement osteotomy technique,it has better safety and is more beneficial to the postoperative recovery of the patients.
作者
李兴鑫
汪丙昂
陈施展
敖江鹏
檀臻炜
娄延举
LI Xing-xin;WANG Bing-ang;CHEN Shi-zhan;AO Jiang-peng;TAN Zhen-wei;LOU Yan-ju(Department of Orthopedics, Air Force Hospital, Western Theater Command, Chengdu 610000, China)
出处
《实用医院临床杂志》
2022年第4期142-146,共5页
Practical Journal of Clinical Medicine
关键词
全膝关节置换
间隙平衡技术
测量截骨技术
截骨量
下肢力线
膝关节功能
Total knee arthroplasty
Gap balancing technique
Measurement osteotomy technique
Osteotomy volume
Lower limb alignment
Knee joint function
