两种入路在全膝关节置换术中的应用比较

Appilication comparison of two approaches for the total knee arthroplasty

目的比较两种入路在全膝关节置换术(TKA)中的应用效果。方法将行TKA治疗的100例膝骨关节炎患者按照手术入路不同分为经内侧髌旁入路组(51例)和经股内侧肌下入路组(49例)。比较两组手术时间、术中出血量、术后引流量、膝关节活动度。采用HSS评分评价膝关节功能。结果患者均获得随访,时间3~5(3.52±0.38)个月。手术时间、术中出血量、术后引流量:两组比较差异均无统计学意义(P>0.05)。术后3个月膝关节HSS评分、末次随访时膝关节屈曲活动度:经股内侧肌下入路组均明显大于经内侧髌旁入路组(P<0.05)。结论与经内侧髌旁入路相比,经股内侧肌下入路行TKA治疗膝骨关节炎具有早期膝关节功能好的优势,且不会延长手术时间及增加术中出血量、术后引流量。

Objective To compare the application effect of two approaches in the total knee arthroplasty(TKA).Methods The 100 patients with knee osteoarthritis treated with TAK were divided into two groups according to different surgical approaches.The 51 cases were treated with medial parapatellar approach,and 49 cases were treated with minisubvastus approach.The operation time,intraoperative blood loss,postoperative drainage volume,and range of motion of the knee joint were compared between the two groups.The HSS score was used to evaluate the function of the knee joint.Results All patients were followed up for 3~5(3.52±0.38)months.Operation time,intraoperative bleeding volume and postoperative drainage volume:there were no significant differences between the two groups(P>0.05).HSS score of knee at 3 months after surgery and knee flexion activity at the last follow-up were significantly larger in the minisubvastus approach group than those in the medial parapatellar approach group(P<0.05).Conclusions Compared with the medial parapatellar approach,the minisubvastus approach has the advantage of good early knee function,and does not prolong the operation time,increase the volume of intraoperative bleeding and postoperative drainage volume.