全膝关节置换后早期疗效:3种假体的比较

Early clinical efficacy in total knee arthroplasty:comparison of three types of prosthesis

背景:全膝关节置换中选择何种假体目前仍存在争议。目的:探讨传统固定平台、旋转移动平台以及高屈曲衬垫膝关节假体置换后的早期疗效。方法:回顾分析2006年1月至2009年12月间接受以上3种假体进行初次人工全膝关节置换的重度骨关节炎患者的资料,比较3组患者置换前及置换后3个月、6个月、1年以及1年以后的KSS评分,SF-36健康调查量表评分以及最大膝关节屈曲度。结果与结论:所有例患者均获随访。3组患者全膝关节置换后的KSS评分、SF-36量表评分以及最大膝关节屈曲度较置换前明显改善(P<0.05);置换后同一时间点组间及组内比较差异无显著性意义(P>0.05)。提示,3种假体对于中晚期膝关节炎患者的早期治疗效果优良,患者满意度佳,可以在一定程度上改善膝关节屈曲度;但未发现3者在早期疗效、患者的主观满意度以及早期关节活动度的改善上存在显著差异。

BACKGROUND：The choice of prosthesis in total knee arthroplasty is stil controversial. OBJECTIVE：To observe the early clinical efficacy of conventional fixation platform, rotation mobile platform and high-flexion prosthesis in total knee arthroplasty. METHODS：The clinical data were analyzed retrospectively from patients undergoing primary total knee arthroplasty for osteoarthritis between January 2006 and December 2009. The KSS score, SF-36 score and maximal range of knee flexion in three groups were recorded at preoperative moment, postoperative 3, 6, 12 months and after 1 year. RESULTS AND CONCLUSION：Al the involved patients were fol owed up. Compared with preoperative data, postoperative KSS score, SF-36 score and maximal range of knee flexion were significantly improved after arthroplasty （P〈0.05）. There was no significant difference in KSS score, SF-36 score and maximal range of knee flexion between three groups at the same time and among different groups at respective time （P〉0.05）. These three kinds of prostheses showed good and excellent clinical efficacy for osteoarthritis, the patients were satisfied, and maximal range of knee flexion was improved. But there is no significant difference on early clinical efficacy, subjective satisfaction of patients and maximal range of knee flexion among the three kinds of prosthesis.