NexGen LPS高屈曲型膝关节假体置换术后中远期效果的研究

Study on the Long-term Effect of LPS NexGen in High Flexion Knee Prosthesis Replacement

目的用普通膝关节假体行TKA后,膝关节安全活动曲度约为100°-110°,如要完成包括下跪、下蹲等高度屈曲动作,必须选用高屈曲度设计假体。本文研究观察为膝关节高度屈曲而设计的Nex Gen LPS高屈曲型人工全膝关节假体置换术后中远期效果。方法回顾性分析我院106例（120膝）接受Nex Gen LPS高屈曲型人工全膝关节假体置换术后8-11年的患者的相关数据,包括术前、术后测量的膝关节屈曲度,及根据KSS膝关节评分系统进行评分。结果获随访106例（120膝）,平均随访时间（123.5±3.2）个月（96-134个月）,KSS术前膝评分平均为（46.3±15.6）分、功能评分平均为（49.5±18.6）分,术后末次随访膝评分平均为（92.7±6.1）分、功能评分平均为（81.6±17.8）分,术前膝屈曲度为〈90°、90°-100°、〉100°的三组患者术后屈曲度平均增加（37.6°±7.2°）,（25.8°±1.9°）和（6.9°±2.1°）,1例出现假体无菌性松动,1例发生感染。结论 Nex Gen LPS高屈曲型人工膝关节假体通过设计上的改进使理论上能达到高度屈曲,但膝关节假体置换后的屈曲度受术前屈曲度等多因素影响,术前活动度较差的患者术后获益更大,并且假体松动、感染等并发症发生率较低,术后总体中远期临床效果满意。

Objective After used the common knee prosthesis in TKA,the knee range of security activities from 100 ° to 110 °. It was including kneeling and squatting high flexion,it must be used a high flexion prosthesis design. Our study aimed to investigate the long-term effect of LPS Nex Gen high flexion total knee prosthesis replacement in the design of knee joint with high flexion. Methods A retrospective analysis of 106 cases of our hospital（120 knees）received Nex Gen LPS high flexion type artificial total knee arthroplasty 8 to 11 years of patient related data, including preoperative and postoperative measurement of knee flexion, and according to the KSS knee joint score system. Results Followed up 106 cases（120 knees）,with an average follow-up time of（123.5±3.2）months（96 to 134 months）. Preoperative KSS knee scoring average on（46.3±15.6）points,functional score in an average of（49.5±18.6）points, postoperative follow-up knee score average on（92.7±6.1）points, function score average of（81.6±17.8）points,preoperative knee flexion degree 90°,90° to 100°,100° of three groups of patients with postoperative flexion increased by an average of（37.6 ° ±7.2 °）,（25.8 ° ±1.9 °）,（6.9 ° ±2.1 °）,1 case had a aseptic loosening,1 case had a infection. Conclusion Nex Gen LPS high flexion knee prosthesis by improving the design of the theory can achieve high flexion,but the knee prosthesis replacement after buckling degree preoperative flexion and influenced by many factors. Patients with preoperative activity less benefit from greater,and has a lower rate of prosthesis loosening,infection and other complication. The overall long-term clinical results were satisfactory after operation