人工膝关节置换术中应用高屈曲旋转平台与固定平台假体的疗效比较

Comparison effects of high flexion rotating platform and fixed platform prosthesis in total knee arthroplasty

目的比较人工膝关节置换术(TKA)中应用高屈曲旋转平台(RPF)假体与高性能固定平台(HFB)假体的临床疗效。方法将83例行TKA的患者(86膝)分为RPF组(46例,47膝)和HFB组(37例,39膝),分别应用RPF假体和HFB假体。比较两组患者术后HSS评分及膝关节活动度。结果两组患者均获得随访,RPF组随访时间为19~30(24.1±3.1)个月,HFB组随访时间为18~30(25.2±3.4)个月。HSS评分:术前RPF组为33.8分±4.1分、HFB组为34.2分±3.7分,末次随访RPF组为90.3分±3.5分、HFB组为89.4分±4.4分;末次随访两组与术前比较差异均有统计学意义(P<0.001),两组之间差异无统计学意义(P>0.05)。膝关节活动度:术前RPF组为86.0°±9.4°、HFB组为84.4°±9.3°,末次随访RPF组为123.8°±18.4°、HFB组为110.8°±9.6°;末次随访两组与术前比较差异均有统计学意义(P<0.001);两组间比较差异有统计学意义(P<0.001)。结论 RPF假体和HFB假体均能获得满意的手术效果和临床疗效,但RPF假体的屈曲度高于HFB假体。

Objective To compare the clinical effect of high flexion rotating platform（ RPF） prosthesis and high performance fixed platform（ HFB） prosthesis in total knee arthoplasty. Methods The 83 patients（ 86 knees） were divided into RPF group（ 46 patients,47 knees） and HFB group（ 37 patients,39 knees）,using RPF and HFB prosthesis,respectively. Two groups of patients with postoperative HSS score and knee joint activity were compared. Results The patients in the two groups were followed up,the follow-up time of RPF group was 19 - 30（ 24. 1 ± 3. 1）months,and the follow-up time of HFB group was 18 - 30（ 25. 2 ± 3. 4） months. The preoperative HSS scores of RPF group was（ 33. 8 ± 4. 1） points,HFB group was（ 34. 2 ± 3. 7） points; at the last follow-up,RPF group was（ 90. 3 ± 3. 5） points,HFB group was（ 89. 4 ± 4. 4） points; at the end of the follow-up,compared with the preoperative,differences were statistically significant（ P〈0. 001）,no statistically significant differences existed between the two groups（ P〈0. 05）. Knee joint activity before operation in RPF group was 86° ± 9. 4°,HFB group was 84. 4° ±9. 3°,at the end of the follow-up of RPF group was 123. 8° ± 18. 4°,HFB group was 110. 8° ± 9. 6°; at the end of the follow-up,compared with the preoperative,differences were statistically significant（ P〈0. 001）; there were significant differences between two groups（ P〈0. 001）. Conclusions RPF and HFB prosthesis can make the patients get satisfactory operation effect and clinical curative effect,but the degree of RPF prosthesis is higher than that of HFB prosthesis.