人工全膝关节置换术治疗老年膝关节病变合并膝外翻畸形的疗效分析

Analysis of clinical effect of the treatment of patients with end-stage gonarthrosis combined with valgus knee deformity by total knee arthroplasty

目的分析人工全膝关节置换术(TKA)治疗老年膝关节病变合并膝外翻畸形的疗效。方法对54例膝关节病变合并膝外翻畸形的老年患者经髌骨旁内侧入路行TKA。观察患者治疗前后临床症状并进行HSS评分,比较患者治疗前后股胫角、膝关节活动度;采用VAS评分及生存质量评分评估治疗效果。结果患者均获得随访,时间10~16个月。末次随访患者股胫角、膝关节活动度及HSS评分均较术前显著改善,差异均有统计学意义(P<0.001);患者末次随访VAS评分及生存质量评分均较术前明显改善,差异均有统计学意义(P<0.001)。结论经髌骨旁内侧入路,通过良好的软组织平衡和恰当的截骨进行TKA治疗老年膝关节病变合并膝外翻畸形患者效果满意。

Objective To analyse the clinical effect of the treatment of patients with end-stage gonarthrosis combined with valgus knee deformity by total knee arthroplasty （TKA）.Methods Total 54 patients with end-stage gonarthrosis combined with valgus knee deformity were selected.All patients received TKA.The clinical symptoms of patients were observed before and after treatment,tibiofemoral angle,knee range,the HSS score,VAS,quality of life scores were recorded.Results Patients were followed up for 10~16 months.At the end of the follow-up,tibiofemoral angle,knee activity of patients and the HSS scores were significantly improved than those before treatment,the difference was statistically significant（P〈0.001）;VAS and quality of life scores of patients were significantly improved than those before treatment,the difference was statistically significant（P〈0.001）.Conclusions TKA is an effective way for the patients with end-stage gonarthrosis combined with valgus knee deformity by medial parapatellar approach combined with conventional osteotomy and Ranawat soft tissue release.The correction of deformity and improvement of joint function can be achieved significantly.