亚洲人人工全膝关节置换术后下肢冠状位力线与临床疗效的相关性研究

Correlation Study between Coronal Line of Lower Limb and Clinical Outcome in Asian Patients after Total Knee Replacement

目的:研究接受初次人工全膝关节置换术的亚洲患者术后下肢冠状位力线矫正与临床疗效的关系。方法:回顾性分析2014年1月-2015年12月在惠州市中心人民医院接受初次人工全膝关节置换术的212例患者的临床资料,将患者按术后HKA角分为轻度内翻组(174°≤HKA<177°,n=114)和完全纠正组(HKA为180°±3°,n=98),采用视觉模拟评分(VAS)和膝关节功能评分(HSS)评价两组患者的临床疗效。结果:两组患者术后的VAS及HSS评分均较术前有显著改善,差异均有统计学意义(P<0.05),且轻度内翻组术后的VAS及HSS评分均优于完全纠正组,差异均有统计学意义(P<0.05)。结论:术后下肢冠状位力线无论是完全纠正还是轻度内翻都可以显著改善患者术前的疼痛,并显著提高膝关节功能。相对而言,由于亚洲人的下肢力线普遍存在轻度内翻特点,因此维持术后下肢力线轻度内翻会得到更好的临床疗效。

Objective：To study the relationship between the correction of lower limb coronal line and the clinical outcome in Asian patients undergoing primary total knee replacement.Method：The clinical data of 212 patients undergoing primary total knee arthroplasty in Huizhou Central People＇s Hospital from January 2014 to December 2015 were analyzed retrospectively,the patients in the postoperative HKA angle divided into mild varus group（174°≤HKA177°,n=114） and completely correct group（HKA was 180°±3°,n=98）,the visual analogue scale（VAS） and hospital for special surgery（HSS） were compared between the two groups.Result：The scores of VAS and HSS in the two groups after operation were significantly improved compared with those before operation,the differences were statistically significant（P〈0.05）,the VAS and HSS scores of the patients with mild varus group were better than those of the complete correction group,the differences were statistically significant（P〈0.05）.Conclusion：The coronal line of the lower extremity,whether complete correction or mild varus,can significantly improve the preoperative pain and significantly improve the function of the knee joint.Relatively speaking,because of the mild inversion features of lower extremity force lines in Asians,it is better to maintain the mild inversion of the lower extremity force line.