高屈曲度假体与旋转平台假体在人工膝关节置换术中的应用价值比较

Comparison on the Application Value of High-flexion Prosthesis and Rotating Platform Prosthesis in Total Knee Arthroplasty

目的:比较高屈曲度假体与旋转平台假体在人工膝关节置换术(TKA)中的应用价值。方法:将2016年1月至2018年5月在我院行TKA术的膝关节病变晚期患者纳入研究范围,置入高屈曲度假体与旋转平台假体患者各50例,对应A、B组。比较两组一般手术情况、临床指标、影像学指标及术后SF-36生活质量评分,并统计并发症发生率。结果:两组一般手术情况、影像学指标及并发症发生率无统计学意义(P>0.05);术后两组膝关节临床评分(KCS)、膝关节功能评分(KFS)、髌股Feller评分、膝关节活动度(ROM)及SF-36评分较术前显著上升(P<0.05),视觉模拟疼痛评分(VAS)较术前显著下降(P<0.05),但组间无统计学意义(P>0.05)。结论:TKA术中,高屈曲度假体与旋转平台假体所表现出的近期疗效相当,但基于理论角度,后者的临床优势仍有待长期随访予以持续探究。

Objective: To compare the application value of high-flexion prosthesis and rotating platform prosthesis in total knee arthroplasty (TKA). Methods: Patients with advanced knee joint pathological changes who underwent TKA in the hospital from January 2016 to May 2018 were enrolled in the study, including 50 patients treated with high-flexion prosthesis (group A) and 50 patients treated with rotating platform prosthesis (group B). The general surgical conditions (surgical time, intraoperative blood loss, loose rate of lateral joint capsule soft tissues, postoperative blood transfusion volume), clinical indicators [knee clinical score (KCS), knee function score (KFS), patellofemoral Feller score, pain visual analogue score (VAS), range of motion (ROM) of knee joint], imaging indexes (femoral angle, tibial angle, posterior slope, femoral flexion angle, Insall-Salvati value) and postoperative SF-36 quality of life scores were compared between the two groups. The incidence of complications was statistically analyzed. Results: There were no significant differences in the general surgical conditions, imaging parameters or incidence of complications between the two groups (P>0.05). KCS, KFS and Feller scores, knee ROM and SF-36 scores of both groups were significantly increased after surgery (P<0.05), while VAS scores were significantly decreased after surgery (P<0.05), There's no significant difference between the two groups (P>0.05). Conclusion: In TKA, the short-term efficacy of high-flexion prosthesis is similar to that of rotary platform prosthesis, but the clinical advantages of the latter need to be explored in a long-term follow-up.