假体内旋与初次全膝关节置换术后疼痛因素的分析

Analysis of internal rotation of the prosthesis and knee pain after primary total knee arthroplasty

疼痛是全膝关节置换术(TKA)后不满意的常见原因,其通常有感染、无菌性松动等因素,但仍有部分患者无法明确病因。近年研究发现术后不明原因疼痛可能和旋转力线不良相关,作者分析了本院32例初次TKA术后不明原因膝痛患者的旋转力线,并将其和无疼痛患者比较,探讨术后疼痛和旋转力线的关系。发现疼痛组患者胫骨旋转角、股骨旋转角、联合旋转角、胫股失匹配角均较无疼痛组内旋,两组比较差异均有统计学意义(P<0.05)。两组术后VAS评分、KSS功能评分、膝关节活动度比较,差异均有统计学意义(P<0.05)。故假体内旋是初次TKA术后不明原因疼痛的一大因素,应避免假体过度内旋安放,减少术后疼痛发生。

Pain is a common cause of dissatisfaction after total knee replacement.The reasons are infection,aseptic loosening and so on,but there are still some patients who can not identify the cause of the pain.Recent studies have found that postoperative unexplained pain may be associated with poor rotational alignment.The study analyzed the rotational alignment of 32 patients with unexplained knee pain after primary TKA,and compared with the patients without pain,to investigate the relationship between postoperative pain and rotational alignment.It was found that the tibial rotation angle,femoral rotation angle,combined rotation angle and tibial femoral offset in the pain group had more significant internal rotation than those in the non pain group,and the differences between the two groups were statistically significant(P<0.05).Two groups of patients after the follow-up VAS score,KSS functional score,range of motion had statistically significant differences(P<0.05).Internal rotation of the prosthesis is a cause of unexplained knee pain after primary total knee arthroplasty,and it should be avoided to reduce postoperative pain in TKA.