高屈曲后稳定型假体在全膝关节置换术中的应用及疗效评估

Application and Efficacy Evaluation of High Flexion Knee Prosthesis System in Total Knee Replacement

目的:评估高屈曲型膝关节假体置换术后的临床疗效。方法:对56例70膝膝关节病残患者进行高屈曲型全膝关节假体置换术。采用正中切口,髌旁内侧入路,行全膝关节置换。通过X线观察假体固定情况,采用美国膝关节学会评分(KSS评分)评定膝评分及膝功能评分。结果:末次随访时,关节活动度(ROM)明显增加,由术前(64.71±24.27)°增加至术后(126.79±8.60)°(110°～135°)。术后最大屈曲角度为(132.07±9.03)°。术前KSS膝评分为(36.36±10.36)分,膝功能评分为(32.50±10.14)分,术后分别为(90.91±4.46)、(78.61±11.61)分。2例骨性关节炎及3例类风湿关节炎患者术后X线提示胫骨假体周围透亮线,宽度<2 mm,表现为非进展性。其余病例假体位置良好,无松动及髌骨脱位。结论:高屈曲型膝关节假体行人工膝关节置换近期疗效可靠,能获得膝关节高屈曲度,但长期疗效有待进一步观察。

Objective To investigate the clinical effects of high-flexion prosthesis in total knee replacement.Methods Total 70 knees in 56 patients with knee joint injury were given total knee replacement.The high-flexion prosthesis was replacd through center incision and patellar medial approach.The fixed situation of prosthesis was observed with X-ray,and the scores of knee and knee function were evaluated with KSS scoring system.Results At final follow-up examination,the range of knee motion was improved from(64.71 ± 24.27) ° preoperatively to(126.79 ± 8.60) ° postoperatively.The maximum flexion was(132.07 ± 9.03) °.The average Knee Society knee scores improved from(36.36 ± 10.36) preoperatively to(90.91 ±4.46),and the average Knee Society function scores improved from(32.50 ± 10.14) scores preoperatively to(78.61 ±11.61) scores.The X-ray examination of two of knees in patients with OA and three of knees in patients with RA showed lucencies around the tibial prosthesis,but the radiolucencies were lower than 2 mm and were nonprogressive.Conclusion Total knee replacement with high-flexion prosthesis can provide satisfactory improvement in knee function for patients with knee joint disease.The short-term effect is definite,but the long-term effect needs further studies.