膝关节翻修术后关节线变化对膝关节功能的影响

Influence of joint line changes on knee joint function after revision total knee arthroplasty

目的探讨膝关节翻修术后关节线位置变化对膝关节功能的影响。方法选取2014年6月至2015年6月在我院行膝关节翻修术患者40例,于术前、术后24个月拍摄标准膝关节正侧位X射线平片,测量关节线,比较关节线变化小于等于2 mm、2~4 mm者、大于4 mm者及使用与未使用股骨金属填充块填充术前术后膝关节功能评分、Feller髌骨评分变化。结果关节线变化小于等于2 mm、2~4 mm者术后膝关节评分、Feller髌骨评分、膝关节功能评分均显著高于关节线变化大于4 mm者,差异均有统计学意义(P <0. 05);使用金属填充块者功能评分及Feller髌骨评分显著高于未使用者,差异均有统计学意义(P <0. 05)。关节线变化在4 mm以上者,Feller评分与关节线变化有关,且呈负相关(r=-0. 685,P <0. 05)。结论膝关节翻修术后关节线变化在4 mm以上者对膝关节功能的影响较大,术中股骨金属填充块的应用对关节功能的恢复有利。

There were 40 patients underwent the revision total knee arthroplasty from June 2014 to June 2015 in our hospital.Before surgery and 24 hours after surgery,the frontal and lateral X-ray plain film of the knee joint were performed.The joint line was measured.The knee function scores and Feller patellar scores in patients with joint line changes ≤2 mm,joint line changes 2~4 mm,joint line changes 〉4 mm or with and without metal fillings in the femur were compared.Results The knee scores,Feller scores and knee function scores in patients with joint line changes ≤2 mm and 2~ 4 mm were significantly higher than those with joint line changes 〉4 mm,the differences were significant（ P 〈0.05）;the knee function scores and Feller scores in patients with metal fillings were significantly higher than those without metal fillings,the differences were significant（ P 〈0.05）.Regarding patients with joint line changes 〉4 mm,the Feller scores were negatively correlated with the joint line changes （ r =-0.685, P 〈0.05）.Conclusion After the revision total knee arthroplasty,the joint line changes 〉4 mm produces a larger effect in the knee joint function.The metal fillings are good for the recovery of the knee joint function.