膝关节置换中的屈曲挛缩与软组织松解

Soft tissue release processing in knee flexion contracture during knee replacement

背景:软组织松解是矫正膝关节屈曲挛缩的主要手段,对不同的膝关节疾病和畸形程度其全膝关节置换中软组织松解方法各不相同。良好合理的软组织平衡使高度屈曲挛缩的膝关节在全膝关节置换后获得明显的功能恢复和畸形矫正。目的:探讨膝关节置换中膝关节的屈曲挛缩与软组织松解的处理。方法:对26例屈膝畸形在20°-60°的初次全膝置换病例进行回顾性研究,记录其全膝关节置换中软组织松解步骤及每步松解后畸形残留情况。全膝关节置换后平均随访12个月。结果与结论:26例膝关节的屈曲畸形在软组织松解后得到纠正。所有病例均进行了不同程度的后关节囊松解,屈曲畸挛缩畸形得到了纠正,活动范围也得到了很大的提高,提示充分的后关节囊及侧副韧带松解可以矫正绝大部分屈曲畸形,增加股骨远端截骨并非必须。

BACKGROUND： Soft tissue releasing is a major means of correcting knee flexion contracture, and the soft tissue releasing methods are different for different knee joint diseases and degrees of deformity. Ideal soft tissue balance can gain a clear functional recovery and deformity correction from severe knee flexion contracture after total knee arthroplasty. OBJECTIVE： To study the proper handling of knee flexion contracture and soft tissue releasing in total knee arthroplasty. METHODS： Twenty-six cases of knee deformity in 20 ° to 60 ° receiving primary total knee arthroplasty were retrospectively studies. Steps of soft tissue releasing and residue deformity after each step were recorded. Postoperative follow-up was 12 months on average. RESULTS AND CONCLUSION： The 26 cases were recovered from knee flexion deformity after soft tissue release. Posterior capsular release was carried out in all cases to different extents, and the flexion deformity and postoperative range were corrected and greatly improved, respectively. These indicate that the posterior capsular release and lateral collateral ligament release can correct most of the flexion deformity, but increasing the distal femoral osteotomy is not necessary.