严重膝关节骨性关节炎行全膝关节置换术的软组织平衡

Soft tissue balance in total knee arthroplasty of knee with serious osteoarthritis

目的回顾严重膝关节骨性关节炎行全膝关节置换术的软组织平衡方法及效果。方法对30例共35侧严重膝关节骨性关节炎行全膝关节置换术资料进行回顾性分析,对术前情况、术中软组织平衡技术、术后效果及关节功能HSS评分情况进行分析。结果35侧膝关节术前关节功能HSS评分平均43.4分,其中26侧膝合并有不同程度的畸形。2例术中残留屈曲畸形者,术后关节活动差,其余病例采用规范化软组织松解方法,达到了良好的软组织平衡,矫正了术前畸形,关节功能满意,出院时HSS评分平均74.3分,随访1年HSS评分平均85.6分,关节功能优良率达88.8%。结论良好的软组织平衡可使严重膝关节骨性关节炎全膝关节置换术后获得畸形矫正和功能恢复,应掌握规范的软组织平衡技术。

Objective To analyze the techniques and effects of soft tissue balance （STB）on total knee arthroplasty （TKA） of knee with serious usteoarthritis. Methods Total 35 knees with serious osteoarthritis were operated with TKA. The preoperative conditions, technique of soft tissue balance, results of operation and the HSS score of joint function were reviewed. Result 26 of the total 35 knees have preoperative deformities, 2 of which could not obtained satisfactory STB. The function of postoperative joint were poor in those two patients. Others who obtained nice STB by canonical loose technique had satisfactory joint functions during the follow-up. The mean HSS score was 43.4 before operation, 74.3 at discharged and 85.6 one year after operation. Conclusion TKA for patients with serious ostcoarthritis can have good results in correction of deformity and improvement of joint function.