GenesisⅡ高屈曲膝假体与普通假体在全膝关节置换术中的早期疗效比较

The Early Clinical Outcome of High-flexion versus Standard Prostheses in Total Knee Arthroplasty

目的比较使用GenesisⅡ高屈曲假体和普通假体行全膝关节置换术（TKA）的患者术后早期疗效,研究高屈曲假体能否增加术后活动度。方法对2007年9月-2011年12月初次行TKA的80例患者（85膝）进行随访,最终符合标准且获得随访60例（60膝）,随访时间2~4年,平均2.7年。其中32例使用GenesisⅡ高屈曲假体（美国Smith＆Nephew公司）,28例使用普通假体,比较术后活动度、美国特种外科医院（HSS）评分及并发症有无差别。结果高屈曲假体组与普通假体组末次随访时的膝关节活动度分别为（112.8±11.0）、（108.9±12.1）°,HSS评分分别为（86.6±11.9）、（84.2±13.3）分,股骨后髁偏心距分别为（25.1±7.3）、（24.5±6.2）mm,差异均无统计学意义（P〉0.05）。截至末次随访时,两组均无患者因松动、骨溶解或其他原因翻修。结论高屈曲膝关节假体并不增加术后活动度,尚需中长期随访研究高屈曲膝关节假体能否真正提高膝关节活动度,且不增加相应的并发症。

Objective To compare the early clinical outcome of Genesis Ⅱ high-flexion versus standard prostheses in total knee arthroplasty（TKA）, and evaluate whether high-flexion prostheses can improve the postoperative range of motion（ROM）. Methods Between September 2007 and December 2011, 80 patients（85 knees） consecutively underwent posterior cruciate-sacrificing TKA with Genesis Ⅱ systems. Finally, we reviewed 60 patients（60 knees） including 32 knees in high-l exion group and 28 knees in standard group. The follow-up time was 2.7 years in average. The postoperative knee ROM and the rate of complication of the two groups were evaluated. Results The mean postoperative knee ROM of 32 knees was 112.8° in the high-flexion group and was 108.9° in the standard group. The mean postoperative HSS score was 86.6 and 84.2, respectively. The postoperative knee ROM, hospital for special surgery（HSS） score and the rate of complication did not show signii cant dif erence between the two groups. Conclusions The high-l exion prosthesis is no better than the ordinary prosthesis in terms of the range of motion. We need more mid to long-term studies to do further research.