两种不同假体对全膝关节置换术后ROM、HSS评分和高屈曲活动能力的影响对比

Comparison of the effects of two different prostheses on ROM,HSS scores and high flexion mobility after total knee arthroplasty

目的比较两种不同假体[旋转平台高屈曲假体(RPF)与旋转平台标准假体(RP)]对全膝关节置换术后膝关节活动度(ROM)、美国特种外科医院(HSS)评分和高屈曲活动能力的影响。方法回顾性将2015年1月至2017年1月收治的60例全膝关节置换术合并RPF或RP假体患者作为研究对象,随访3个月至1年。比较RPF与RP两种不同假体全膝关节置换术后ROM、HSS评分、高屈曲活动能力、术后髌骨倾斜角及Insall-Salvati比值的差异。结果 36例患者采用RPF假体,24例患者采用RP假体。比较全膝关节置换术后RPF组与RP组ROM、HSS评分,均提示差异无显著性(P>0.05);全膝关节置换术后RPF组与RP组患者可以完成蹲起等高屈曲动作的比率分别为41.67%(15/36)、45.83%(11/24),提示差异无显著性(P>0.05)。两组患者术后髌骨倾斜角和髌骨摩擦音发生率的比较,均差异无显著性(P>0.05);而RPF组Insall-Salvati比值较RP组组明显降低(P<0.01)。结论 RPF与RP两种不同假体对全膝关节置换术后患者而言,均有效改善术后关节疼痛和膝关节功能,置换RPF与RP两种不同假体术后ROM、HSS评分和高屈曲活动能力并无显著差异。

Objective To compare the effects of two different prostheses[high flexion rotating platform（RPF） and rotary platform standard prosthesis（RP） ] on range of motion（ROM）,the hospital special surgery（HSS） score and high flexion ability after total knee arthroplasty.Methods From January 2015 to January 2017,60 cases of total knee arthroplasty with RPF or RP prosthesis were selected as the subjects and followed up for 3 months to 1 years. The differences of two different prostheses of RPF and RP on ROM,HSS score,high flexion ability after total knee replacement,patellar tilt angle and Insall-Salvati ratio after operation were compared. Results RPF prosthesis was used in 36 patients and RP prosthesis in 24 patients. There was no significant difference in ROM and HSS scores between group RPF and group RP after total knee replacement（P〉0. 05）. The ratio of high flexion to crouch in group RPF and group RP after total knee replacement was 41. 67%（15/36） and45. 83%（11/24）,indicating no significant difference（P〉0. 05）. There was no significant difference in the patellar tilt angle and the incidence rate of patellar fricative sounds between the two groups（P〉0. 05）. The Insall-Salvati ratio in group RPF was significantly lower than that in group RP（P 〈0. 01）. Conclusion The two different prostheses of RPF and RP are effective in improving postoperative joint pain and knee joint function,but there is no significant difference in the postoperative ROM,HSS score and high flexion ability between the two different prostheses of RPF and RP.