CR型假体和CS型假体膝关节置换的中期疗效比较

Comparison of mid-term outcomes between CR prosthesis and CS prosthesis for knee arthroplasty

目的比较后交叉韧带保留型膝关节假体(CR型假体)和后稳定型膝关节假体(CS型假体)在膝关节置换中的应用效果。方法回顾性分析2017年1月至2018年1月于商洛市商州区人民医院骨科接受膝关节置换术治疗的90例患者的临床资料,依据不同假体分为CR组和CS组,每组45例,比较两组患者的围术期情况、不同时间点膝关节活动度、最大屈曲角度和膝关节美国特种外科医院(HSS)评分的变化。结果CR组患者的手术时间为(84.34±7.69)min,明显短于CS组的(95.11±8.50)min,术中出血量、术后引流量分别为(348.55±37.02)mL、(210.17±15.63)mL,均明显少于CS组的(390.11±42.31)mL、(289.57±20.41)mL,差异均有统计学意义(P<0.05);CR组患者术后1个月时膝关节活动度、最大屈曲角度、膝关节HSS评分分别为(97.34±4.58)°、(99.81±5.22)°、(72.02±7.58)分,CS组分别为(97.90±4.22)°、(99.50±5.73)°、(71.78±8.12)分,CR组术后3个月时分别为(104.89±7.30)°、(105.27±7.50)°、(86.63±6.04)分,CS组分别为(105.10±6.94)°、(105.44±7.20)°、(87.01±5.36)分,CR组术后1年时分别为(106.67±5.3)°、(109.29±5.11)°、(92.92±3.05)分,CS组分别为(106.22±5.89)°、(109.64±4.75)°、(93.11±2.76)分,差异均无统计学意义(P>0.05)。结论CR型假体和CS型假体均可有效促进膝关节置换术后关节功能的恢复,而CR型假体具有手术时间短、术后出血量及引流量少等特点,但在今后的临床应用上仍需根据不同患者综合情况选择合适的假体置入方式。

Objective To the compare the application effect between posterior cruciate ligament retaining(CR)prosthesis and posterior cruciate ligament substituting prosthesis(CS)prosthesis for knee arthroplasty.Methods A retrospective analysis was made on the clinical data of 90 patients who underwent knee arthroplasty in Department of Orthopaedics,Shangluo Shangzhou District People's Hospital from January 2017 to January 2018.According to the different prostheses used,the patients were divided into CR group and CS group,with 45 patients in each group.The perioperative conditions,the changes of knee motion,maximum flexion angle,and Hospital for special surgery(HSS)score at different time points were compared between the two groups.Results The operation time in CR group was(84.34±7.69)min,which were significantly shorter than(95.11±8.50)min in CS group;the intraoperative bleeding volume and postoperative drainage volume were(348.55±37.02)mL and(210.17±15.63)mL,which were significantly less than(390.11±42.31)mL and(289.57±20.41)mL in CS group;the differences were statistically significant(P<0.05).The knee motion,maximum flexion angle,and HSS score were(97.34±4.58)°,(99.81±5.22)°,(72.02±7.58)points in the CR group and(97.90±4.22)°,(99.50±5.73)°,(71.78±8.12)points in the CS group at 1 month after operation,(104.89±7.30)°,(105.27±7.50)°,(86.63±6.04)points in the CR group and(105.10±6.94)°,(105.44±7.20)°,(87.01±5.36)points in the CS group at 3 month after operation,(106.67±5.3)°,(109.29±5.11)°,(92.92±3.05)points in the CR group and(106.22±5.89)°,(109.64±4.75)°,(93.11±2.76)points in the CS group at 1 year after operation;there was no significant difference between the two groups(P>0.05).Conclusion CR prosthesis and CS prosthesis can effectively promote the recovery of joint function after knee arthroplasty,while CR prosthesis has the characteristics of short operation time,less blood loss,and less drainage.However,in the future clinical application,it's still necessary to select suitable prosthesis placement according to the comprehensive situation of different patients.