有序软组织平衡技术在外翻畸形全膝关节置换术中的应用

Orderly soft tissue balance in valgus deformity application of total knee replacement

目的探讨在膝外翻畸形人工全膝关节置换(TKA)术中应用有序软组织平衡技术的手术方法及早期临床效果。方法收集2017年7月—2019年6月期间62例膝关节外翻畸形患者,应用有序软组织平衡技术行TKA手术,手术分6个步骤有序完成。术后观察患者KSS临床与功能评分、股骨和胫骨解剖轴线夹角(FTA角)、膝关节活动度(ROM)变化并与术前比较,评估手术效果。结果所有患者均得到随访,随访时间5~26个月;患者置换术前与末次随访时的KSS临床及功能评分、FTA角、膝关节活动度对照,差异均有统计学意义(P<0.05);术后1例患者存在膝关节内侧不稳症状,术后佩戴支具8周恢复。结论应用有序软组织平衡技术对膝关节外翻畸形行人工全膝关节置换治疗,能有效矫正软组织失衡恢复膝关节正常的力线,并可避免过度松解导致膝关节不稳,有临床应用价值。

Objective To explore the operation method and early clinical effect of orderly soft tissue balance technique in TKA.Methods 62 patients with genu valgus from July 2017 to June 2019 were collected.TKA was performed by using the technique of orderly soft tissue balance.The operation was completed in six steps.The clinical and functional scores of KSS,the angle between femur and tibia(FTA angle)and ROM of knee joint were observed and compared with those before operation.Results All patients were followed up for 5-26 months.There were significant differences in KSS clinical and functional scores,FTA angle and knee joint activity between the patients before and at the last follow-up(P<0.05).One patient had symptoms of medial instability of knee joint and recovered after 8 weeks.Conclusion The results showed that the application of ordered soft tissue balance technology in the treatment of knee valgus deformity with total knee arthroplasty can effectively correct the imbalance of soft tissue and restore the normal force line of the knee joint,and avoid the instability of the knee joint caused by excessive loosening,which has clinical application value.