全膝关节置换术中入路方式对临床疗效的影响

Effect of approach method on clinical efficacy in total knee arthroplasty

目的探讨全膝关节置换术(TKA)中入路方式对临床疗效的影响。方法将115例接受TKA治疗的患者根据手术入路不同分为A组(采用经股肌下结合微斜切入路,58例)和B组(采用经股肌下入路,57例)。比较两组术后疼痛VAS评分、KSS评分、膝关节活动度及影像学指标。结果患者均获得随访,时间12~14个月。疼痛VAS评分、KSS评分、膝关节活动度:术后1个月A组均优于B组(P<0.05、P<0.01);末次随访时两组比较差异均无统计意义(P>0.05)。两组末次随访影像学指标比较差异均无统计学意义(P>0.05)。结论经股肌下结合微斜切入路与经股肌下入路TKA均可获得良好的疗效,但经股肌下结合微斜切入路具有术后早期患者疼痛感较轻、膝关节功能恢复更快的优点。

Objective To investigate the effect of approach method on clinical efficacy in total knee arthroplasty(TKA).Methods The 115 patients receiving TKA were divided into group A(58 cases were treated with subfemoral approach combined with micro oblique approach)and group B(57 cases were treated with subfemoral approach).At the postoperation,the pain VAS,KSS score,knee range of motion and imaging indexes were compared between the two groups.Results All patients were followed up for 12~14 months.Pain VAS,KSS score and knee range of motion:at 1 month after operation,group A was better than group B(P<0.05,P<0.01);there were no significant differences between the two groups at the last follow-up(P>0.05).There was no significant difference in imaging indexes between the two groups at the last follow-up(P>0.05).Conclusions Both the subfemoral oblique approach combined with micro oblique approach and the subfemoral oblique approach TKA can obtain good curative effects,but the subfemoral oblique approach has the advantages of lower pain VAS and faster recovery of knee function in the early postoperative period.