固定平台与旋转平台假体全膝关节表面置换术治疗膝关节骨性关节炎的早期疗效观察

Observation on early clinical efficacy of fixed platform and rotating platform in knee prosthesis arthroplasty for osteoarthritis of the knee

目的 观察PFC固定平台假体与RP旋转平台假体两种人工膝关节置换系统治疗成年人膝关节骨性关节炎术的早期疗效.方法 对39例（39膝）膝关节骨性关节炎患者行全膝关节置换术（TKA）.根据术中采用的假体类型不同而分为两组：固定平台组和旋转平台组.其中,固定平台组16例;旋转平台组23例,术后观察伤口愈合情况、患者行走步态和膝关节活动度.结果 3例术后发生深静脉血栓,经保守治疗,症状好转出院;2例术后伤口脂肪液化,经换药后伤口愈合,按时拆线出院.随访3～ 12个月访（平均10个月）,所有患者均能直立行走而无明显跛行.末次随访时固定平台组、旋转平台组膝关节评分（HSS）与膝关节活动度（ROM）分别为（83.17 ±7.12）分、（81.32±5.39）分和（109.73±6.35）＆#176;、（103.12±4.28）＆#176;,与术前差异有统计学意义（A组HSS：t =22.10,ROM：t =9.21;B组HSS：t=30.69,ROM：t =9.54,均P＜0.01）,但组间差异无统计学意义（HSS：t =0.88,ROM：t=3.63,均P＞0.05）.结论 采用PFC与RP假体系统行全膝关节表面置换早期均有良好疗效,两者早期关节功能改善差异无统计学意义,但远期疗效需要进一步观察.

Objective To observe the early clinical efficacy of PFC fixed platform and RP rotating platform prosthesis two kinds of artificial knee replacement system for the treatment of knee osteoarthritis.Methods 39 cases （39 knees）with knee osteoarthritis were treated with total knee arthroplasty（TKA）.According to intraoperative use of different types of prosthesis,the cases were divided into two groups：fixed platforms group 16 cases and rotating platform group 23 cases.The wound healing,patients with gait and knee activity after operation were observed.Results Three cases took place postoperative deep vein thrombosis,after conservative treatment,the symptoms improved and discharged,two cases of postoperative wound fat liquefaction,by dressing wound healing,time stitches discharged.3 to 12 months follow-up visit（average 10 months）,all patients could walk uptight without noticeable limp.Last follow-up group,fixed platforms,rotating platform group Knee Score （HSS） and knee activity （ROM） were （83.17 ± 7.12）,（81.32 ± 5.39） points and （109.73 ± 6.35） ＆#176;,（103.12 ± 4.28） ＆#176;,compared with the preoperative differencewasstatisticallysignificant （AgroupHSS：t =22.10,ROM：t =9.21 ; BgroupHSS：t =30.69,ROM：t =9.54,all P 〈 0.01）,but the difference between groups was not statistically significant（HSS：t =0.88,ROM：t =3.63,all P 〉 0.05）.Conclusion Using PFC and RP prosthesis after total knee replacement system in early has a good effect,both of which improve joint function early with no significant difference,but long-term effects need further observation.