多尺寸人工全膝关节系统的临床应用分析及随访结果

Clinical application analysis and follow-up results of multi-size total knee prosthesis system

目的 探讨应用多尺寸膝关节假体系统的临床应用优势及早期随访结果.方法 回顾性分析自2010年12月至2012年12月78例应用Vanguard膝关节系统进行人工全膝表面关节置换患者.术中记录应用股骨假体型号,术后定期门诊随访,拍摄X线片,应用KSS评分和WOMAC评分评估手术效果.结果 78例患者平均随访15.8个月.术前KSS评分（34.68±8.07）分,WOMAC评分（62.40±3.74）分,术后末次随访KSS评分（84.99±3.64）分,WOMAC评分（25.86±3.31）分.术前患者膝关节平均屈曲度（95.83°±13.83°）,术后末次随访时患者膝关节平均屈曲度（122.63°±9.93°）.患者术后膝关节功能明显改善,评分具有统计学差异（P〈0.01）.常用股骨假体型号在55～70 mm之间,并且70%以上集中在60～65 mm.结论 Vanguard膝关节假体能满足不同个体的需求,适应性强,有利于伸屈间隙的平衡,假体覆盖好,早期随访临床效果满意.

Objective To discuss the benefits of multi-size totle knee prosthesis system and the early follow-up results. Methods 78 patients underwent total knee arthroplasty （TKA） with Vanguard complete knee system from December 2010 to December 2012. The femoral prosthesis size was recorded. HSS and WOMAC were used to evaluate the overall outcomes in the follow-up. Results 78 patients were followed up for 15.8 months in average. The preoperative KSS score was （ 34. 68 ± 8.07 ） , and the WOMAC score was （62.40 ± 3.74）. At the last follow-up, the postoperative KSS score was （ 84.99 ± 3.64） and the WOMAC score was （25.86 ± 3.31 ）. The average knee flexion degree was （95.83° ± 13.83°） preoperation. At the last follow-up, the average knee flexion degree was （122. 63° ± 9.93°）. The postoperative knee function improved significantly. The scores had statistically significant difference. The common femoral prosthesis size was 55 - 70 mm, and the size of more than 70% prostheses was between 60 -65 mm. Conclusion The Vanguard complete knee system can meet the needs of different individuals, and it is good for the balance of the flexion and extension gap. The early follow-up clinical outcomes are satisfactory.