初次全膝关节置换术中两种胫骨假体旋转对线方法的对比

Comparison of two rotation alignment methods of tibial prosthesis in primary total knee arthroplasty

目的探讨初次全膝关节置换术中两种胫骨假体旋转对线方法的临床效果。方法选取2017年2月至2019年2月在本院接受初次全膝关节置换术治疗的手术患者70例作为本次的研究对象,根据患者的入院时间随机分为两组。对照组35例,采用基于Insall线行胫骨假体旋转对线技术,试验组35例,采用基于Akagi线行胫骨假体旋转对线技术。采用膝关节功能评分表对全膝关节置换术术后患者的临床疗效进行评估,通过CT影像数据对胫骨假体旋转角度机进行测量并对比。结果术前两组患者KSS评分比较,差异无统计学意义(P>0.05);术后末次随访,两组患者的KSS评分比较,差异无统计学意义(P>0.05);两组术后末次随访KSS评分均高于术前,两组比较,差异有统计学意义(P<0.05)。对照组KSS评分总优良率为82.86%,试验组为91.43%,两组比较,差异无统计学意义(P>0.05)。试验组末次随访的胫骨假体旋转角度总体优于对照组,两组比较,差异有统计学意义(P<0.05);试验组的胫骨假体外旋角度小于对照组,内旋角度大于对照组,且试验组的胫骨假体外旋占比少于对照组,胫骨假体内旋占比多于对照组,两组比较,差异有统计学意义(P<0.05)。结论在初次全膝关节置换术后,与基于Insall线行胫骨假体旋转对线技术相比,基于Akagi线行胫骨假体旋转对线技术进行治疗能够有效减少术后发生胫骨假体旋转不佳的情况,临床治疗效果更佳,患者术后的生活质量也更好,值得在临床中应用和推广。

Objective To explore the clinical effect of two rotation alignment methods of tibial prosthesis in primary total knee arthroplasty. Methods Seventy surgical patients who were treated with primary total knee arthroplasty in our hospital from February 2017 to February 2019 were selected as the subjects of this study, and were randomly divided into two groups according to the admission time of the patients. In the control group(35 patients),the tibial prosthesis was rotated by Insall line, while in the experimental group(35 patients), the tibial prosthesis was rotated by Akagi line.The clinical efficacy of patients after total knee arthroplasty was evaluated by using knee function rating scale. The rotation angle machine of tibial prosthesis was measured and compared with CT image data. Results No significant difference was observed in KSS scores between the two groups before surgery(P>0.05).At the last follow-up after surgery,no significant difference was observed in KSS scores between the two groups(P>0.05).The last follow-up KSS scores were higher in both groups than those before surgery,and the difference between the two groups was statistically significant(P<0.05).The total excellent and good rate of the KSS score in the control group was 82.86%,and that in the experimental group was 91.43%,with no statistically significant difference between the two groups(P>0.05). The rotation angle of tibial prosthesis in the experimental group at the last follow-up was generally better than that in the control group,and the difference between the two groups was statistically significant(P<0.05).The external rotation angle of the tibial prosthesis in the experimental group was less than that in the control group,and the internal rotation angle of the tibial prosthesis in the experimental group was greater than that in the control group, with statistically significant differences between the two groups(P<0.05). Conclusion After primary total knee arthroplasty, compared with rotating alignment technique of tibial prosthesis based on Insall line,treatment with rotating alignment technique of tibial prosthesis based on Akagi line can effectively reduce the poor rotation of tibial prosthesis after surgery,with better clinical therapeutic effect and better postoperative quality of life of patients.Therefore,it is worthy of application and promotion in clinical practice.