应用膝关节旋转半月板解剖型和固定半月板解剖型假体手术治疗膝退行性骨关节炎的临床分析

Application of knee joint meniscus dissection type and fixed type meniscus dissection implant surgery for the treatment of knee degenerative osteoarthritis

目的探讨应用膝关节旋转半月板解剖型和固定半月板解剖型假体治疗膝退行性骨关节炎的临床疗效。方法2009年2月—2013年1月选择在我院进行住院治疗的膝退行性骨关节炎患者132例,根据随机原则分为观察组与对照组各66例,行人工膝关节置换手术治疗,分别将旋转膝关节假体和固定膝关节假体进行人工植入固定,采用美国膝关节外科学会的评分系统(KSS)对患膝在术后当日与术后3个月进行膝关节评分和功能评分。结果所有患者都顺利完成手术,术中无严重并发症发生。随访3个月,观察组与对照组的总显效率分别为93.9%和80.3%,组间比较差异有统计学意义(P<0.05)。观察组的髌骨不稳、感染和下肢深静脉血栓形成等并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。两组术后当天的膝关节评分和功能评分比较无统计学差异,术后3个月时评分都明显上升,同时评分在组内与组间比较有统计学差异(P<0.05)。结论人工膝关节置换手术治疗膝退行性骨关节炎有较好的预后,而旋转假体的应用能更加有效改善患膝屈伸活动和功能,疗效满意。

Objective To investigate the effect of knee joint meniscus dissection type and fixed type meniscus dissection implant surgery for the treatment of knee degenerative osteoarthritis. Methods From Feb 2009 to Jan 2013, 132 cases with knee degenera- tive osteoarthritis were retrospectively analyzed. They were divided into observation group （ n = 66） and the control group （ n = 66） according at random. Total knee joint replacement surgery was performed with knee joint meniscus dissection type and fixed type meniscus dissection implant respectively. The American society for knee surgery scoring system （KSS） was adopted for knee func- tional evaluation on the day after surgery and the postoperative 3 months. Results All patients were successfully completed surgery and no serious intraoperative complications occurred. Cases in the observation group and control group were followed up for 3 months and the total efficiency were 93.9% and 80.3% respectively, difference was significant between the two groups （P 〈 0.05 ）. Incl- dence of complications such as patellar instability, infection and lower extremity deep vein thrombosis in observation group was lower than the control group, compared with significant difference （P 〈 0.05 ）. There was no significant difference of postoperative knee scoring and function score comparison on the day after operation. 3 months after operation the scores raised up significantly and at the same time scores between groups and in groups were found with significant difference （ P 〈 0.05 ）. Conclusion Artificial knee joint replacement surgery is good for the treatment of knee degenerative osteoarthritis and has better prognosis. The application of ro- tation prosthesis can be more effective for improving knee flexion and extension function, curative effect is satisfied and is worthy of popularization and application.