GEMINI MKⅡ微创技术在胫骨高位截骨术后患者膝关节置换中的应用及临床研究

Application of GEMINI MKⅡ in total knee arthroplasty treatment after high tibial osteotomy

目的探讨GEMINI MKⅡ在胫骨高位截骨术(HTO)术后患者全膝关节置换中的临床应用。方法选择25例(27膝)HTO术后需进行全膝人工关节置换术(TKA)治疗的患者作为研究对象,采用GEMINI MKⅡ人工假体进行TKA手术治疗,分别于术前、术后1、6个月及12个月观察膝关节功能评分、Feller髌骨评分等疗效指标以及膝关节屈曲度、患者满意度等临床指标。结果患者术后膝关节屈曲度显著增加,由术前的(93.80±12.64)°增加至术后1、6个月以及12个月的(123.29±11.39)°、(124.70±13.38)°以及(127.95±7.82)°,差异有统计学意义(均P<0.05);随着随访时间的推移,患者膝关节功能评分(KSS评分)、Feller髌骨评分以及患者满意度等指标不断显著增加,其中患者满意度由术后1个月的70.37%显著增加至术后6个月的81.48%以及12个月的96.30%,差异有统计学意义(均P<0.05);KSS评分由术前的(45.88±6.37)分显著增加至术后1个月的(54.03±6.74)分、6个月的(76.50±6.33)分以及12个月的(93.82±5.48)分,差异有统计学意义(均P<0.05);Feller髌骨评分由术前的(17.94±2.98)分增加至术后1个月的(18.03±1.11)分、6个月的(23.25±2.00)分以及12个月的(27.63±3.11)分,差异有统计学意义(均P<0.05)。结论 HTO手术后需进行TKA手术的患者,GEMINI MKⅡ型人工膝关节假体治疗效果确切肯定,对改善膝关节功能、疼痛等效果显著。

Objective To explore the clinical application of GEMINI MK Ⅱ in treatment of TKA after HTO. Methods 25 patients （27 knees） received TKA treatment after HTO were selected. GEMINI MK Ⅱ was utilized in TKA treatments. Knee function score, Feller patella score, knee flex angle and satisfaction of treatment were observed and compared before treatment, 1, 6 and 12 months after treatments. Results A immediate significant increase of knee flex angle was observed after surgeries, from （93.80±12.64）° before surgeries to （123.29±11.39）°, （124.70±13.38）° and （127.95±7.82）° for 1, 6 and 12 month after surgeries （all P 〈 0.05）; Knee function score, feller patella score and satisfaction of treatment increased significantly after GEMINI MK Ⅱ treatment over time： satisfaction rate of treatment was increased from 70.37% for 1 month after surgeries to 81.48% for 6 month and 96.30% for 12 month after surgeries （all P 〈 0.05）; Knee function score was increased from （45.88±6.37） before surgeries to （54.03±6.74）, （76.50±6.33） and （93.82±5.48） for 1, 6 and 12 month after surgeries （all P 〈 0.05）; Feller patella score was increased from （17.94±2.98） before surgeries to （18.03±1.11）, （23.25±2.00） and （27.63±3.11） for 1, 6 and 12 month after surgeries with the signifant differences （all P 〈 0.05）. Conclusion GEMINI MK Ⅱ shows positive and confirmed effects in TKA treatment after HTO, improving knee function and pain significantly.