股骨后髁偏心距对接受后稳定型全膝关节置换的骨性关节炎患者术后功能恢复的影响

Effect of Posterior Condylar Offset on Postoperative Functional Recovery in Patients with Osteoarthritis Undergoing Posterior Stable Total Knee Arthroplasty

目的:探讨股骨后髁偏心距(PCO)对接受后稳定型全膝关节置换(PS-TKA)的骨性关节炎患者术后功能恢复的影响。方法:选择本院2016年1月-2020年1月收治的接受PS-TKA手术治疗的膝关节骨性关节炎患者89例,根据手术前后股骨后髁偏心距变化进行分组,差值≥0的患者为A组(53例),<0的患者归为B组(36例)。比较两组术前及术后12个月美国膝关节协会评分(KSS)、西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评分及膝关节活动度(ROM)。结果:两组术前KSS、WOMAC各项评分比较,差异均无统计学意义(P>0.05);两组术后12个月KSS、WOMAC各项评分均明显优于术前,差异均有统计学意义(P<0.05),但术后12个月两组的KSS、WOMAC各项评分比较,差异均无统计学意义(P>0.05)。两组术前主动与被动ROM比较,差异均无统计学意义(P>0.05),而两组术后12个月上述指标均较术前改善,差异均有统计学意义(P<0.05);术后12个月,两组主动ROM比较,差异无统计学意义(P>0.05),A组被动ROM优于B组,差异有统计学意义(P<0.05)。结论:PCO对骨性关节炎患者PS-TKA术后膝关节及下肢功能、疼痛等评价指标无明显影响,但与术后PCO减小患者相比,PCO不变或增大者可获得更好的膝关节被动活动度。

Objective:To investigate the effect of posterior condylar offset(PCO)on postoperative functional recovery in patients with osteoarthritis undergoing posterior stable total knee arthroplasty(PS-TKA).Method:A total of 89 patients with knee osteoarthritis treated by PS-TKA in our hospital from January 2016 to January 2020 were divided into two groups according to the changes of posterior condylar offset before and after operation,the patients with difference≥0 were divided into group A and patients with difference<0 were divided into group B(36 cases).The Knee Society Score(KSS),Western Ontario and McMaster University(WOMAC)osteoarthritis index score and range of motion(ROM)of the two groups were compared before and 12 months after operation.Result:There were no significant differences in KSS and WOMAC scores between the two groups before operation(P>0.05);and the KSS and WOMAC scores of the two groups at 12 months after operation were significantly better than those before operation,the differences were statistically significant(P<0.05),but there were no significant differences in KSS and WOMAC scores between the two groups at 12 months after operation(P>0.05).There were no significant differences between the two groups in active and passive ROM before operation(P>0.05),12 months after surgery,the above indexes in both groups were improved compared with those before surgery,the differences were statistically significant(P<0.05);12 months after operation,there was no significant difference in active ROM between the two groups(P>0.05),but the passive ROM in group A was better than that in group B,the differences were statistically significant(P<0.05).Conclusion:PCO has no significant effect on knee joint and lower limb function,pain and other evaluation indexes in patients with osteoarthritis after PS-TKA,but compared with patients with reduced PCO after PS-TKA,patients with constant or increased PCO can obtain better passive motion of knee joint.