外侧半月板切除继发膝外翻的全膝关节置换术临床效果观察

Clinical effect of total knee arthroplasty in treatment of patients with valgus knee deformity after lateral meniscectomy

目的：探讨膝关节外侧半月板切除术后出现继发性膝外翻骨关节炎患者施行全膝关节置换的手术方法和临床疗效。方法使用全膝关节表面置换术治疗26例继发于外侧半月板切除术后的膝外翻畸形，对比手术前后膝关节活动度、股胫角变化及 KSS 评分，评价手术疗效。结果术后随访5个月至3年，膝关节平均活动度由术前的96°提高到116°，KSS 评分平均80.4分，较术前22.5分提高了57.9分；功能评分平均84.4分，较术前25.5分提高了58.9分。本组患者术后外翻畸形基本得到纠正，随访股胫角0?9°，平均7.6°，较术前明显改善，外翻畸形基本得到纠正。结论膝关节外侧半月板切除术后继发外翻畸形后行全膝关节表面置换，可获得比较满意的临床效果。

Objective To evaluate the clinical efficacy of total knee arthroplasty(TKA)in patients of osteo-arthris with valgus knee deformity after lateral meniscectomy(LMT). Methods Twenty six cases of osteo-arthris with valgus knee deformity after lateral meniscectomy were treated with total knee arthroplasty. Operation evaluations including the range of motion(ROM),the tibial and femur angle(T-F angle),Knee Society Score System(KSS)and the function score were performed as follow-up. Results The median follow-up periods was 22 months and ranged from 5 months to 3 years. The average ROM improved from 96° preoperatively to 116° at postoperatively. The average KSS improved from 22. 5 points preoperatively to 84. 4 points postoperatively. The average function score improved from 25. 5 points preoperatively to 84. 4 points postoperatively,and the average T-F angle was corrected from 22°( 13° - 31°) of valgus preoperatively to 7. 6°( 0° - 9°) of valgus postoperatively. Conclusion The TKA can provide excellent in patients undergoing osteo-arthris with valgus knee deformity after lateral meniscectomy.