全膝关节置换术中应用高屈曲假体和普通假体对患者膝关节功能评分及活动度影响的对比分析

Comparative analysis of the effect of high flexion prosthesis and common prosthesis on knee function score and mobility in total knee arthroplasty

目的研究全膝关节置换术中应用高屈曲假体和普通假体对患者膝关节功能评分及活动度的影响。方法选取2017年3月至2018年12月本院收治的56例拟行全膝关节置换术患者作为研究对象,按治疗方式不同分为旋转平台标准假体(RP)组(n=22)和旋转平台高屈曲假体(RPF)组(n=34)。比较两组美国特种外科医院(HSS)、关节活动度(ROM)评分、解剖学变量、并发症发生率和高屈曲活动能力。结果术前,两组HSS、ROM评分比较差异无统计学意义;术后1年,两组HSS、ROM评分比较差异无统计学意义,但均高于术前,差异有统计学意义(P<0.05)。RP组Insall-Salvati比值高于RPF组,差异有统计学意义(P<0.05);两组髌骨倾斜角比较差异无统计学意义。两组髌骨摩擦音发生率比较差异无统计学意义(χ2=0.427,P>0.05);两组高屈曲活动能力测试中可下蹲率比较差异无统计学意义(χ2=0.573,P>0.05)。结论在全膝关节置换术中,RP和RPF两种假体均可有效改善膝关节功能和术后关节疼痛,两种假体在高屈曲活动能力、HSS评分和ROM评分方面均无显著差异。

Objective To explore the comparative analysis of the effect of high flexion prosthesis and common prosthesis on knee function score and mobility in total knee arthroplasty.Methods 56 patients underwent total knee arthroplasty in our hospital from March 2017 to December 2018 were selected as the study subjects.According to different treatment methods,they were divided into rotating platform standard prosthesis(RP)group(n=22)and rotating platform high flexion prosthesis(RPF)group(n=34).The US hospital for special surgery(HSS),range of motion(ROM)score,ananatomical variables,complication rate,and high flexion mobility were compared between the two groups.Results There was no statistically significant difference in HSS and ROM scores between the two groups before surgery;there was no significant difference in HSS and ROM scores between the two groups at 1 year after surgery,but they were all higher than those before surgery,and the difference was statistically significant(P<0.05).The Insall-Salvati ratio of the RP group was higher than that of the RPF group,and the difference was statistically significant(P<0.05);there was no significant difference between the two groups of patella tilt angle.There was no significant difference in the incidence of patella friction between the two groups(χ2=0.427,P>0.05);there was no significant difference in the squat rate between the two groups in the high flexion mobility test(χ2=0.573,P>0.05).Conclusion In total knee arthroplast,both RP and RPF prosthesis can effectively improve knee function and postoperative joint pain.There is no significant difference between the two prothesis in terms of high flexion activity,HSS score and ROM score.