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[1]馬千里 鄭玉云 吳敏瑞 劉 暉 陳 強(qiáng).骨性關(guān)節(jié)炎38例膝內(nèi)側(cè)單髁置換術(shù)后的早中期療效[J].福建醫(yī)藥雜志,2018,40(06):61-63.
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骨性關(guān)節(jié)炎38例膝內(nèi)側(cè)單髁置換術(shù)后的早中期療效()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
40
期數(shù):
2018年06期
頁碼:
61-63
欄目:
臨床研究·
出版日期:
2018-11-29

文章信息/Info

文章編號(hào):
1002-2600(2018)06-0061-04
作者:
馬千里 鄭玉云 吳敏瑞 劉 暉 陳 強(qiáng)
廈門大學(xué)附屬福州第二醫(yī)院骨科(福州 350007)
關(guān)鍵詞:
膝關(guān)節(jié) 間室 骨性關(guān)節(jié)炎 單髁 早中期療效
分類號(hào):
R684.3
文獻(xiàn)標(biāo)志碼:
B
摘要:
目的 評(píng)估膝內(nèi)側(cè)單髁置換術(shù)后的早中期療效。 方法 對(duì)38例內(nèi)側(cè)膝關(guān)節(jié)骨性關(guān)節(jié)炎行單髁置換術(shù)(均為Ahlback 2級(jí)以上內(nèi)側(cè)間室膝關(guān)節(jié)炎,無臏股關(guān)節(jié)炎表現(xiàn),保守治療無效),采用牛津3代活動(dòng)墊片型單髁假體,使用小創(chuàng)口手術(shù)入路,術(shù)前和最后的評(píng)估通過KSS評(píng)分系統(tǒng)。術(shù)后X線片評(píng)估采用牛津標(biāo)準(zhǔn)。平均隨訪時(shí)間24(18~32)個(gè)月。結(jié)果 術(shù)前平均膝關(guān)節(jié)屈曲度121.8(110~130)度,術(shù)后130.9(120~140)度(P<0.05)。膝關(guān)節(jié)伸直術(shù)前術(shù)后均無受限。平均術(shù)前和術(shù)后膝關(guān)節(jié)KSS評(píng)分分別是64.6(47~80)分和97.5(80~100)分,其中術(shù)前和術(shù)后的平均功能分分別是59.6(45~80)分和92.1(70~100)分。當(dāng)患者功能分好時(shí),膝關(guān)節(jié)綜合評(píng)分(knee society score, KSS)也好,其中27例(71.1%)為極好,11例為好(28.9%)。術(shù)后X線片檢查提示,所有患者股骨部件的位置均在可接受范圍內(nèi),平均3度外翻(5度外翻到8度內(nèi)翻),0.5度伸直(伸直3度到2度屈曲)。股骨部件的位置與機(jī)械軸的關(guān)系:30例在中心,8例側(cè)移2 mm。所有患者脛骨部件的位置均在可接受范圍,平均1.5度內(nèi)翻(從內(nèi)翻2度到外翻2度),平均后傾6.2(5~7)度。除一例有4 mm前側(cè)移位外,余患者脛骨部件和平臺(tái)前、后、內(nèi)、外一致。所有患者聚乙烯內(nèi)襯均在中心并平行于脛骨部件。未發(fā)現(xiàn)會(huì)導(dǎo)致膝關(guān)節(jié)撞擊的骨贅和骨水泥碎片。隨訪到最后,所有部件均在位,無脫位、感染、肺栓塞、深部靜脈血栓、神經(jīng)血管損傷等并發(fā)癥,無翻修。結(jié)論 只要選擇合適手術(shù)指征,嚴(yán)格遵守外科操作,牛津3代活動(dòng)墊片型單髁假體置換治療膝關(guān)節(jié)內(nèi)側(cè)間室骨性關(guān)節(jié)炎的早中期療效滿意。

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更新日期/Last Update: 2018-11-29