Deluxe-PS型与PFC Sigma RP型假体在膝关节置换中的比较

Application of Deluxe-PS and PFC Sigma RP prostheses in knee joint replacement

背景:目前在临床中常采取人工膝关节置换修复各种重度或保守治疗终期的膝关节疾患,取得十分理想的疗效。Deluxe-PS型膝关节假体和PFC Sigma RP型膝关节假体置换各具优势。目的:对比分析Deluxe-PS型及PFC Sigma RP型膝关节假体与骨截面的匹配性。方法:根据使用的膝关节假体将87例膝关节炎双侧膝关节置换患者分为2组,试验组46例采取Deluxe-PS型膝关节假体置换,对照组41例采取PFC Sigma RP型膝关节假体置换。对比两组患者的手术时间、手术出血量差异;采用美国膝关节协会评分、美国特种外科医院膝关节评分、膝关节活动度分别对两组患者置换前、置换后3个月、末次随访时的膝关节功能进行评估;置换后拍摄正侧位X射线片,测量外翻角、股骨假体屈曲角度。结果与结论:1试验组的手术时间、手术出血量均显著优于对照组(P<0.05);2两组置换前、置换后3个月、末次随访时的美国膝关节协会评分、美国特种外科医院膝关节评分及膝关节活动度组间比较差异均无显著性意义(P>0.05),两组置换后3个月、末次随访时的上述指标均较置换前显著改善(P<0.05);3试验组和对照组置换后末次随访时的外翻角、股骨假体屈曲角度测定值组间比较差异均无显著性意义(P>0.05);4结果提示,Deluxe-PS型人工膝关节假体用于双侧膝关节置换的效果与PFC Sigma RP型膝关节假体相当,能够较完美地实现假体和骨截面的高精度结合,增强假体和截骨覆盖面的融合适合性,但是Deluxe-PS型人工膝关节假体具有手术操作方面的优势,该优势可能与Deluxe-PS型假体更符合国人膝关节解剖结构有关。

BACKGROUND：During artificial knee replacement for all kinds of severe knee disease or conservative treatment for end-stage knee disease,Deluxe-PS knee prosthesis and PFC Sigma RP knee prosthesis have their advantages.OBJECTIVE：To compare and analyze the matching of the Deluxe-PS and PFC Sigma RP knee prostheses with bone cross section.METHODS：According to the use of the knee prosthesis,87 gonarthritis patients undergoing bilateral knee replacement were divided into two groups.46 cases in the test group received Deluxe-PS knee prosthesis replacement.41 cases in the control group received PFC Sigma RP knee prosthesis replacement.Operation time and intraoperative blood loss were compared between the two groups.American Knee Society score,knee score of American Special Surgical Hospital and knee joint range of motion were used to evaluate knee joint function before replacement,3 months after replacement and during final follow-up.Anteroposterior X-ray films were obtained after replacement to measure valgus angle and flexion angle of femoral prosthesis.RESULTS AND CONCLUSION：（1） Operation time and intraoperative blood loss were significantly better in the test group than in the control group（P〈0.05）.（2） No significant difference in American Knee Society score,knee score of American Special Surgical Hospital and knee joint motion was detected between the two groups before replacement and 3 months after replacement（P〉0.05）.Above indexes were significantly improved in both groups at 3 months after replacement and during final follow-up（P〈0.05）.（3） No significant difference in valgus angle and flexion angle of femoral prosthesis was identified between test and control groups during final follow-up（P〉0.05）.（4） These findings indicate that effect of Deluxe-PS type artificial knee prosthesis was identical to that of PFC Sigma RP knee prosthesis in knee osteoarthritis patients receiving bilateral knee joint replacement.Deluxe-PS type artificial knee prosthesis can perfectly realize high-accuracy combination of the prosthesis and the bone cross section,and enhance the fusion suitability of the prosthesis and the bone surface.Deluxe-PS type artificial knee prosthesis has the advantage of operation.This advantage is possibly because Deluxe-PS type artificial knee prosthesis is more in line with the anatomical structure of the knee joint of Chinese.