运动学对线技术在全膝关节置换术患者中的应用价值研究

Study on application value of kinematic alignment technique in patients undergoing total knee arthroplasty

目的探讨将运动学对线技术使用在全膝关节置换术中的临床效果。方法选取行全膝关节置换术的106例患者为研究对象,随机分为对照组(53例)与观察组(53例)。对照组患者术中采取机械对线技术,观察组患者术中应用运动学对线技术。比较两组术后疼痛程度、影像学指标、膝关节恢复情况、膝关节主动屈曲角度、并发症发生率。结果术后3 d、6个月,两组患者的视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05)。术后6个月,两组患者的髌骨倾斜角、Blackburne-Peel指数与髌股指数比较,差异无统计学意义(P>0.05);但观察组患者的外侧髌股角(9.71±4.36)°小于对照组的(11.86±4.15)°,比较差异有统计学意义(P<0.05)。两组患者的术后首次下地时间、术后首次直腿抬高>30°时间以及术后6个月牛津大学膝关节评估问卷(OKS)评分比较,差异无统计学意义(P>0.05)。术后3 d、6个月,两组患者的膝关节主动屈曲角度比较,差异无统计学意义(P>0.05)。两组术后并发症发生情况比较,差异无统计学意义(χ^(2)=0,P=1>0.05)。结论在全膝关节置换术中采用运动学对线技术可在一定程度上减少髌股外侧倾斜,也能保证良好的术后关节恢复及关节活动度,不会产生明显的并发症问题,在手术难度及风险等方面均体现出可靠的应用价值。

Objective To explore the clinical effect of kinematic alignment technique in patients undergoing total knee arthroplasty.Methods 106 patients who underwent total knee arthroplasty were selected as the study subjects.They were randomly divided into a control group(53 cases)and an observation group(53 cases).The control group was treated with mechanical alignment technique during surgery,while the observation group was treated with kinematic alignment technique during surgery.The postoperative pain level,imaging indicators,knee joint recovery,active knee flexion angle,and complications of the two groups were compared.Results At 3 d and 6 months after surgery,there was no significant difference in visual analogue scale(VAS)scores between the two groups(P>0.05).At 6 months after surgery,there were no significant differences in patellar inclination angle,Blackburne-Peel index and patellofemoral index between the two groups(P>0.05).At 6 months after surgery,the observation group had smaller lateral patellofemoral angle of(9.71±4.36)°than(11.86±4.15)°in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups of patients in terms of the first postoperative ambulation time,the time of the first postoperative straight leg raise>30°,and the Oxford knee score(OKS)score at 6 months after surgery(P>0.05).There was no statistically significant difference in the active knee flexion angle between the two groups of patients at 3 d and 6 months after surgery(P>0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(χ^(2)=0,P=1>0.05).Conclusion The use of kinematic alignment technique in total knee arthroplasty can reduce lateral patellofemoral tilt to a certain extent,and ensure good postoperative joint recovery and range of motion without significant complications.It demonstrates reliable application value in terms of surgical difficulty and risk.