全膝关节置换术两种胫骨假体旋转对线比较

Comparison of two rotation alignment techniques of tibial component in the total knee arthroplasty

[目的]对比TKA两种胫骨假体旋转对线技术临床应用效果。[方法]回顾性研究100例单膝OA终末期行单侧TKA手术患者,其中,49例采用胫骨结节中内1/3作为胫骨假体定位标志,51例采用胫骨结节中点作为胫骨假体定位标志,比较两组围手术期、随访和影像资料。[结果]两组患者均顺利完成手术,术中未发生神经、血管损伤等严重并发症。两组在手术时间、切口长度、术中出血量等比较差异无统计学意义(P>0.05)。随访时间12~21个月,平均(14.21±5.34)个月,随时间推移,两组患者ROM和HSS评分均显著增加,而WOMAC评分显著减少,不同时间点差异有统计学意义(P<0.05)。术后3、12个月中点组的ROM和HSS评分显著高于内1/3组(P<0.05),而中点组WOMAC评分显著低于内1/3组(P<0.05)。影像方面,术后两组患者膝关节假体贴服良好,无移位,无假体松动。下肢力线均得以矫正。[结论]以胫骨结节中点胫骨假体放置,术后早期效果显著优于胫骨结节中内1/3胫骨假体放置。

[Objective]To compare the clinical outcomes of two rotation alignment techniques of tibial component in total knee arthroplasty(TKA).[Methods]A retrospective study was conducted on 100 patients who underwent primary unilateral TKA in our hospitals.Of them,49 patients had TKA performed by the medial one third of tibial tuberosity as the mark for rotation alignment of tibial component,while the remaining 51 patients were by the midline of tibial tuberosity as the mark for rotation alignment of tibial component.The perioperative,follow-up and radiographic documents were compared between the two groups.[Results]All patients in both 2 groups had TKA performed smoothly without serious complications,such as nerve and blood vessel injuries.There were no statistical differences regarding to operation time,incision length and intraoperative blood loss between the two groups(P<0.05).As time went during the follow up period lasted from 12 to 21 months with a mean of(14.21±5.34)months,the ROM and HSS score significantly increased,whereas the WOMAC score significantly decreased in both groups(P<0.05).The midline group proved significantly superior to the one third group in ROM,HSS and WOMAC scores at 3 and 12 months postoperatively(P<0.05).With respect to radiographic assessment,all patients in both groups had proper prosthetic fitness on the bones with good recovery of lower limb alignment on images.[Conclusion]This study demonstrates that the clinical outcomes of rotation alignment of tibial component on midline of tibial tuberosity are considerably superior to those on medial one third of tibial tuberosity for primary TKA.