全膝关节置换治疗膝外翻畸形的疗效观察

The curative effect of total knee arthroplasty in the treatment of deformity of knee valgus

目的探讨全膝关节置换术治疗成年膝外翻畸形患者的手术技巧和疗效观察。方法 2015年1月至2017年5月本院收治的膝外翻畸形38例共40膝,年龄46～73(61±4.2)岁。胫股角(FTA)7°～35°(11°±4.3°),患侧膝关节平均活动度为80°～110°(93°±17°),美国特种外科医院(HSS)评分为21～65(43±8.6)分。行全膝关节置换术纠正畸形,改善功能。结果所有患者均获得随访,时间为6个月至3年。患者均无明显的膝关节疼痛或功能障碍。术后FTA1°～7°(4°±3°);患侧膝关节平均活动度为115°±10°;HSS评分(76±14)分;与术前比较差异均有统计学意义(P<0.05)。结论全膝关节置换术是治疗成年膝外翻畸形的常规方法,术中选择合理的入路,准确的截骨,恰当的软组织松解,能获得满意的关节功能和临床疗效。

Objective To discuss the surgical technique and effectiveness of total knee arthroplasty （TKA） for the valgus knee in adult. Methods Retrospective analysis the clinical data from 2015 January to 2017 May of 38 patients with 40 knees treated in our hospital. Age 46 -73（61 ±4. 2）years old. The femur -tibia angle （VFA） was 7° -35°（11° ±4. 3°） ,the average range of motion （ROM） was 115° ±10°, the Hospital for Special Surgery （HSS） score was 21 -65 （43 ± 8.6）. All cases were corrected deformity and improved function by TKA. Results 38 patients were followed up 6 months to 3 years. All patients had no severe pain and dysfunction. The postoperative FTA was 1° -7°（4 ＋3°） ,the average ROM was 115° ±10°, the HSS score was 76 ± 14, showing significant difference compared with preoperative data （P 〈 0. 05）. Conclusions The TKA is a conventional therapy for valgus deformed knee in adult. By appropriate approach, precise osteotomy, accurate soft tissue balance, satisfactory joint function and effectiveness can be achieved.