高屈曲型与普通型假体人工全膝关节置换后的早期功能恢复比较

Ordinary and high-flexion total knee prosthesis replacement:Comparison of early postoperative functional rehabilitation

背景:高屈型假体理论上优于普通型假体,尤其是在置入后关节屈曲度方面。目的:评价高屈曲型与普通型假体单侧人工全膝关节置换后早期的功能康复之间的差异。方法:回顾性对照分析新疆医科大学第四附属医院骨科中心初次行人工全膝关节置换的133例患者141膝,植入假体分别为高屈曲型与普通型,比较两组患者置入后疗效。结果与结论:置入后高屈组1例发生一过性腓总神经麻痹,1例置入后切口愈合不良,42例44膝获随访,失访2例3膝,随访12～19个月;普通型2例发生切口愈合不良,1例浅静脉血栓,86例91膝获随访,失访3例3膝,随访12～23个月。置入后1年两组HSS评分、疼痛评分、肌力评级比较,差异无显著性意义(P>0.05)。高屈曲型在活动度、屈曲挛缩度方面优于普通型(P<0.05)。说明高屈曲型假体单侧人工全膝关节置换早期在关节活动范围和屈曲挛缩度方面评分优于普通型。

BACKGROUND：High-flexion total knee prosthesis is superior to ordinary one,especially in the joint flexion after implantation.OBJECTIVE：To evaluate the difference between ordinary and high-flexion prostheses in early functional rehabilitation following unilateral total knee arthroplasty.METHODS：We retrospectively analyze 133 cases with 141 knees undergoing ordinary or high-flexion prostheses replacement at the Orthopaedic Center,the Fourth Affiliated Hospital of Xinjiang Medical University.Post-implantation effects were compared between two different types of prostheses.RESULTS AND CONCLUSION：After implantation,there were 1 case of transient peroneal nerve palsy and 1 case of poor wound healing in the high-flexion group;totally 42 cases with 44 knees were follow-up for 12-19 months,and there were 2 cases with 3 knees lost.In the ordinary group,there were 2 cases of poor wound healing and 1 case of superficial vein thrombosis;86 cases with 91 knees were followed-up for 12-23 months,and 3 cases with 3 knees were lost.At 1 year after implantation,the HSS score,visual analog scale score,and strength rating had no difference between the two groups（P 0.05）.However,the range of motion and the degree of flexion contracture in the high-flexion group were superior to the ordinary group（P 0.05）.These indicate that in the early stage,the high-flexion prosthesis is better than the ordinary prosthesis in the range of motion and the degree of flexion contracture.