全膝关节置换术中精确截骨的疗效观察

Obsevration of the effect of exact resection in total knee arthroplasty

目的:探讨精确截骨在全膝关节置换术中的临床应用价值。方法:分析我院骨科行全膝关节置换术的病例40例,将其分为两组:常规截骨组(常规组)与精确截骨组(精确组)。在手术前后X线片上测量髋-膝-踝角(hip-knee-ankle angle,HKA);股骨外翻角(knee physical valgus angle,KPV);胫骨内侧平台后倾角(posterior slopeangle,PSA)等。采用KSS评分标准计算两组的优良率,通过优良率比较两组的近期疗效,同时对相关数据进行统计学分析比较,评价两组近期疗效及其相关影响因素。结果:精确组20例,疗效优16例、良2例、可2例、差0例,优良率90%。常规组20例,疗效优12例、良4例、可4例、差0例,优良率80%。同时,精确组相对常规组有较好的术后关节活动恢复情况,下肢力线改善情况,两组间差异有显著性。结论:精确截骨较常规截骨的疗效更为肯定,并且近期功能恢复快、并发症少且下肢力线改善满意,是全膝关节置换术中可选择的理想方法。

Aim：To investigate the clinical value of the application of exact resection method in the total knee arthroplasty（TKA）. Methods： Forty cases were underwent TKA in our hospital.They were divided into two groups： routine resection group and exact resection group.Radiographs were taken preoperatively and postoperatively and the hip-knee-ankle angle（HKA）,knee physical valgus angle（KPV）,posterior slope angle（PSA） were measured.We used the KSS Scores to make out the excellence rate of clinical outcome and to compare the different excellence rate of the two groups.Moreover,through statistical comparison of the posterior slope of the medial tibia plateau,knee physical valgus angle,hip-knee-ankle angle,we evaluated the clinical outcomes and their related factors.Results： There were 20 cases in the exact resection group were evaluated.According to the KSS Scoring,we found excellent in 16 cases,good in 2 cases,moderate in 2 cases,poor in 0 cases and the excellence rate was 90%.While there were also 20 cases in the routine resection group were also studied.And also according to the KSS Scoring,we found excellent in 12 cases,good in 4 cases,moderate in 4cases,poor in 0 cases and the excellence rate was 80%.Improvement on the degrees of axial alignment of the lower extremity and the recovery of joint motion the knee in the exact resection group were much better than in routine resection group.Conclusion：The clinical outcomes of the treatment for knee osteoarthritis by using exact resection method are better than that by using routine resection method.Treating knee osteoarthritis with exact resection method has an excellent short-term functional restoration of the knee and better recovery of force line of lower extremity and fewer complications.As the result,analysis shows that exact resection method is a favorable method in total knee arthroplasty.