旋转活动平台假体在老年全膝关节置换术中的应用研究

Study on the Rotating-platform Prosthesis in Elderly Total Knee Replacement

目的探讨旋转活动平台假体和固定平台型假体在老年全膝关节置换术中近期临床疗效。方法选取符合标准的患者60例,随机分为观察组和对照组各30例,观察组应用旋转活动平台假体,对照组应用固定平台型假体,比较临床治疗效果。结果两组患者术后切口均Ⅰ期愈合,无严重并发症发生。术后1年,两组患者膝评分、功能评分、疼痛评分及髌骨评分较同组治疗前均显著改善,差异均有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05)。术后1年,两组患者膝关节伸直角度及屈曲角度较同组治疗前均显著改善,差异均有统计学意义(P<0.05);两组患者术后1年膝关节伸直角度比较,差异无统计学意义(P>0.05),但是观察组患者屈曲角度优于对照组,差异有统计学意义(P<0.05)。结论老年膝骨性关节炎全膝关节置换术应用旋转活动平台假体或固定平台型假体近期临床疗效相似,但旋转活动平台假体能够更好地改善关节屈曲角度,更符合膝关节原本的生理学运动特征。

Objective To discuss the recent clinical efficacy of rotating-platform prosthesis and fixed-bearing prosthesis in elderly total knee replacement.Methods 60 patients were divided randomly into observation group（30 cases） and control group（30 cases）.The observation group was treated with rotating-platform prosthesis,the control group was treated with fixed-bearing prosthesis,then clinical efficacy was compared.Results All patients＇ postoperative incision wereⅠhealing,and without serious complications.After 1 year,scores of knee,function,pain,patellar in two groups were significantly improved（P〈0.05）,but there was no statistically significant difference between the observation and control group（P〉0.05）;The angle of knee joint straight and flexion in two groups were significantly improved（P〈0.05）,but there was no statistically significant difference of knee joint straight angle between the observation and control group（P〉0.05）,the flexion angle in the observation group was better than the control group（P〈0.05）.Conclusion Rotating-platform prosthesis or fixed-bearing prosthesis in total knee replacement with elderly knee osteoarthritis had similar clinical efficacy,but rotating-platform prosthesis could better improve the angle of knee joint flexion,and more conformed to physiological characteristics of knee joint.