CR假体与PS假体在膝关节骨性关节炎全膝关节置换术中的应用效果

Application effects of CR prosthesis and PS prosthesis in total knee arthroplasty for knee osteoarthritis

目的分析保留后交叉韧带型(CR)假体与后交叉韧带替代型(PS)假体在膝关节骨性关节炎全膝关节置换术中的应用效果。方法将医院2020年1月至2022年1月收治的80例行全膝关节置换术治疗的膝关节骨性关节炎患者作为研究对象,以术中采用不同的假体将其分为CR假体组(40例,CR假体)和PS假体组(40例,PS假体)。比较两组的应用效果。结果CR假体组的术中出血量、术后引流量少于PS假体组,术后第3天的疼痛评分低于PS假体组,住院时长短于PS假体组(P<0.05)。CR假体组的术后并发症总发生率显著低于PS假体组(P<0.05)。术后3、6个月,CR假体组的膝关节肌肉力量总功值及平均功率均低于PS假体组(P<0.05)。术后1、3、6个月,CR假体组的膝关节功能评分量表(HSS)评分均低于PS假体组(P<0.05)。结论在膝关节骨性关节炎全膝关节置换术的假体选择中,CR假体较之PS假体可最大程度保留本体感觉,减少术中出血量,减轻术后疼痛与降低术后并发症发生率,但其术后膝关节肌肉力量与功能的恢复效果低于PS假体,可见两者各有优势与缺点,在临床选择中需严格把握适应证并综合患者的具体情况选择假体类型。

Objective To analyze the application effects of posterior cruciate retaining(CR)prosthesis and posterior cruciate stabilizing(PS)prosthesis in total knee arthroplasty for knee osteoarthritis.Methods A total of 80 patients with knee osteoarthritis who underwent total knee arthroplasty in the hospital from January 2020 to January 2022 were selected as the research objects.According to the different prosthesis used in the operation,the patients were divided into CR prosthesis group(40 cases,CR prosthesis)and PS prosthesis group(40 cases,PS prosthesis).The application effects of the two groups were compared.Results The intraoperative blood loss and postoperative drainage volume of the CR prosthesis group were less than those of the PS prosthesis group,the pain score on the 3rd day after operation was lower than that of the PS prosthesis group,and the hospital stay was shorter than that of the PS prosthesis group(P<0.05).The total incidence of postoperative complications in the CR prosthesis group was significantly lower than that in the PS prosthesis group(P<0.05).At 3 and 6 months after operation,the total power and average power of knee joint muscle strength in the CR prosthesis group were lower than those in the PS prosthesis group(P<0.05).At 1,3 and 6 months after operation,the Hospital Special Surgery(HSS)score of the CR prosthesis group was lower than that of the PS prosthesis group(P<0.05).Conclusion In the prosthesis selection of total knee arthroplasty for knee osteoarthritis,CR prosthesis can retain proprioception to the greatest extent,decrease intraoperative blood loss,alleviate postoperative pain and reduce the incidence of postoperative complications compared with PS prosthesis,but the recovery effect of postoperative knee joint muscle strength and function is lower than that of PS prosthesis.It can be seen that both have their own advantages and disadvantages.In clinical selection,it is necessary to strictly grasp the indications and select the prosthesis type according to the specific conditions of the patients.