全膝置换术治疗伴膝外翻畸形膝骨性关节炎

Total knee replacement in treatment of severe osteoarthris with valgus knee

目的 探讨保留后交叉韧带型全膝人工关节置换术治疗重度膝关节炎伴膝外翻的临床应用价值。方法使用保留后交叉韧带型全膝人工关节置换术治疗8例膝关节炎伴膝外翻。术前X线测量膝外翻畸形10°～35°，平均21．6°。随访6-36个月，平均21个月。根据HSS膝关节百分评分系统进行评估。结果术后X线测量膝外翻角度3°～9°，平均5．7°。HSS膝关节评分术前平均54分，术后91分；活动范围术前平均83°，术后118°。所有病例术后无明显疼痛，行走、上下楼梯等功能较术前明显改善。结论保留后交叉韧带型全膝人工关节置换术治疗膝关节炎伴膝外翻的早期临床疗效满意，术中外侧软组织的松解是手术的关键。后期疗效有待进一步随访观察。

Objective To evaluate the clinical results of the PCL - retaining total arthroplasty in treatment of knee esteoarthris with valgus. Methods From June 2002 to January 2005, 8 cases of osteoarthris with valgus knee were treated with PCL - retaining total knee replacement. The X - ray before operation showed average 21.6 degrees （ranging from 10 to 35 degrees） valgus. The cases were followuped from 6 to 36 months, each of them was evaluated with the Special Surgery Knee Scoring System. Resuits The X - ray after operation showed average 5.7 degrees （ranging from 3 to 9 degrees） valgus. The average HSS scores increased from preoperative 54 to postoperative 91. The range of motion was significandy improved from preoperative 83 degrees to postoperative 118 degrees. All of the cases were no pains after operation, and the function of knees were apparently improved. Conclusions The preliminary clinical results are quite satisfactory for the PCL - retaining total arthroplasty in treatment of osteoarthris with valgus knee. The adequate relaxing and balancing of soft tissue is the key factor to the success of total knee arthroplasty. The follow - up is necessary for further long - term outcome.