人工全膝关节置换治疗成人膝外翻畸形的疗效观察

Clinical research on total knee replacement for valgus knee

目的:探讨全膝关节置换术治疗膝关节外翻畸形的临床疗效和手术方法。方法:2008年1月-2011年6月,对16例(18膝)膝关节外翻畸形的患者进行手术,手术方法:选用髌旁内侧入路、适当的截骨、选择性的外侧软组织松解,进行手术治疗膝关节外翻畸形。术后定期随访测量FTA角、膝关节活动度并行KSS评分及功能评分。结果:所有患者均进行了随访,随访时间12～48个月。FTA角由术前的13.4°降低到7.3°;膝关节活动度由术前的77.4°提高到110.5°;KSS评分由术前的43.9分提高到85.1分,差异均有统计学意义(P<0.01)。结论:所有患者进行全膝关节置换手术后外翻畸形均得到纠正,行走及上下楼梯等功能较术前得到明显改善,取得满意的临床效果。

Objective：To evaluate the clinical efficacy and surgical methods of the total knee arthroplasty（TKA） in patients with valgus knee deformity. Methods： From January 2008 to June 2011, the total knee arthroplasty were performed in 18 knees of 16 patients whose ROM of knees was average 77.4 ° （65 °- 100 °） , femoral-tibial angle was average 14.9 ° （ 10 °- 35 °） and KSS scores was average 43.9 points （13 points 62 points）. The patients were performed by means of medial parapatel lar approach, proper osteotomy and soft tissue balance for knees with valgus knee deformity. Femoral-tibial angle, ROM of knee and KSS score were evaluated during follow-up. Results： All patients were followed up for 12 to 48 months. The average femoral-tibial angle decreased from 13.4° preoperatively to 7.3° postoperatively. The average ROM improved from 77.4° preoperatively to 110.5° postoperatively and the average KSS improved from 43.9 points preoperatively to 85.1 points postoperatively. The difference is significant （P〈0.01 ）. Conclusion：The valgus deformity in all the patients was corrected after total knee arthroplasty and marked improvement of function （walking, going upstairs and downstairs） was found postoper atively. The quality of life was improved in most of the patients.