目的:分析全膝关节置换术中髌旁内、外侧入路治疗中重度膝关节外翻畸形的临床疗效。方法:选取利川市人民医院2018年1月~2022年12月收治行人工膝关节表面置换术治疗中重度膝关节外翻畸形患者60例为本次研究对象,其中骨关节炎36例,类风湿...目的:分析全膝关节置换术中髌旁内、外侧入路治疗中重度膝关节外翻畸形的临床疗效。方法:选取利川市人民医院2018年1月~2022年12月收治行人工膝关节表面置换术治疗中重度膝关节外翻畸形患者60例为本次研究对象,其中骨关节炎36例,类风湿关节炎24例。根据患者手术方式分为内侧组28例、外侧组32例,内侧组采用髌旁内侧入路,外侧组采用髌旁外侧入路。分别比较2组一般基线资料、术中相关情况及末次随访膝关节功能等。结果:术前2组基线资料差异比较均无统计学意义(P > 0.05),研究具有可比性;外侧组手术时间较内侧组手术时间更长,差异具有统计学意义(P P > 0.05);术后末次随访2组在HSS评分及WOMAC评分差异比较有统计学意义(P Objective: To analyze the clinical effect of medial and lateral parapatellar approaches in the treatment of moderate and severe knee valgus deformity during total knee arthroplasty. Methods: Sixty patients with moderate and severe knee valvaration deformity treated by surface replacement of artificial knee joint from January 2018 to December 2022 in the Fourth Affiliated Hospital of Xinjiang Medical University were selected as the subjects of this study, including 36 cases of osteoarthritis and 24 cases of rheumatoid arthritis. Patients were divided into the internal test group (28 cases) and the lateral group (32 cases) according to the surgical method. The internal test group took the parapatellar medial approach and the lateral group took the parapatellar lateral approach. General baseline data, intraoperative relevant conditions and knee function at the last follow-up were compared between the two groups. Results: There was no significant difference in baseline data between the two groups before surgery (P > 0.05), and the studies were comparable. The operative time of the lateral group was longer than that of the medial group, and the difference was statistically significant (P P > 0.05). There were significant differences in HSS score and WOMAC score between the two groups at the last follow-up (P < 0.05). Conclusion: The lateral parapatellar approach can achieve better clinical results in the treatment of moderate and severe genu valva malformations. Compared with the medial parapatellar approach, the lateral parapatellar approach can provide better medial soft tissue tension balance, obtain good patellar trajectory, and shorten the operation time. Long-term follow-up of the lateral parapatellar approach can obtain higher knee functional scores, and experienced surgeons can be the first choice for the treatment of moderate and severe knee valvaration.展开更多
目的评估微创前外侧肌间隙入路联合股骨颈保留在全髋关节置换术中的应用效果。方法回顾性分析2019年1月至2022年1月在渭南市第二医院接受全髋关节置换术的83例患者临床资料,其中42例采用微创前外侧肌间隙入路全髋关节置换术,并保留股骨...目的评估微创前外侧肌间隙入路联合股骨颈保留在全髋关节置换术中的应用效果。方法回顾性分析2019年1月至2022年1月在渭南市第二医院接受全髋关节置换术的83例患者临床资料,其中42例采用微创前外侧肌间隙入路全髋关节置换术,并保留股骨颈,设为观察组;41例采用传统后外侧入路全髋关节置换术,设为对照组。观察组中男20例,女22例,年龄(63.75±6.76)岁;对照组中男23例,女18例,年龄(63.49±6.57)岁。比较两组患者的围手术期指标,术前和术后1 d的血清肌酸磷酸激酶(CPK)水平,术前和术后12个月的视觉模拟评分法(VAS)评分、髋关节Harris评分、Berg平衡量表(BBS)评分、步态参数、两侧肢体长度差、髋臼旋转中心的纵向及横向位移。采用t检验、χ^(2)检验。结果观察组患者的手术时间、术中出血量、切口长度、术后1 d引流量、术后1 d CPK水平分别为(60.26±7.41)min、(210.45±33.94)ml、(7.71±1.96)cm、(82.35±8.48)ml、(384.75±29.76)U/L,对照组分别为(68.97±8.35)min、(328.15±42.06)ml、(11.27±2.43)cm、(117.89±12.12)ml、(668.40±45.94)U/L,差异均有统计学意义(t=5.029、14.047、7.355、15.510、33.299,均P<0.001)。术后12个月,观察组的VAS评分、髋关节Harris评分、BBS评分、步频、最大步速、单足支撑时间百分比、足底压力差分别为(0.67±0.21)分、(90.45±9.37)分、(52.71±3.14)分、(96.79±8.12)步/min、(89.94±10.63)cm/s、(46.59±5.31)%、(9.02±1.03)%,对照组分别为(0.89±0.27)分、(82.63±8.04)分、(45.42±4.83)分、(81.14±7.59)步/min、(80.21±9.87)cm/s、(40.87±5.16)%、(10.61±2.12)%,差异均有统计学意义(t=4.137、4.084、8.131、9.074、4.323、4.977、4.329,均P<0.001)。影像学检查结果显示,观察组患者术后12个月的双侧肢体长差、纵向与横向的髋臼旋转中心位移均低于对照组(t=5.473、7.707、10.698,均P<0.001)。结论微创前外侧肌间隙入路联合股骨颈保留有助于全髋关节置换术后恢复,改善患者髋关节功能。展开更多
文摘目的:分析全膝关节置换术中髌旁内、外侧入路治疗中重度膝关节外翻畸形的临床疗效。方法:选取利川市人民医院2018年1月~2022年12月收治行人工膝关节表面置换术治疗中重度膝关节外翻畸形患者60例为本次研究对象,其中骨关节炎36例,类风湿关节炎24例。根据患者手术方式分为内侧组28例、外侧组32例,内侧组采用髌旁内侧入路,外侧组采用髌旁外侧入路。分别比较2组一般基线资料、术中相关情况及末次随访膝关节功能等。结果:术前2组基线资料差异比较均无统计学意义(P > 0.05),研究具有可比性;外侧组手术时间较内侧组手术时间更长,差异具有统计学意义(P P > 0.05);术后末次随访2组在HSS评分及WOMAC评分差异比较有统计学意义(P Objective: To analyze the clinical effect of medial and lateral parapatellar approaches in the treatment of moderate and severe knee valgus deformity during total knee arthroplasty. Methods: Sixty patients with moderate and severe knee valvaration deformity treated by surface replacement of artificial knee joint from January 2018 to December 2022 in the Fourth Affiliated Hospital of Xinjiang Medical University were selected as the subjects of this study, including 36 cases of osteoarthritis and 24 cases of rheumatoid arthritis. Patients were divided into the internal test group (28 cases) and the lateral group (32 cases) according to the surgical method. The internal test group took the parapatellar medial approach and the lateral group took the parapatellar lateral approach. General baseline data, intraoperative relevant conditions and knee function at the last follow-up were compared between the two groups. Results: There was no significant difference in baseline data between the two groups before surgery (P > 0.05), and the studies were comparable. The operative time of the lateral group was longer than that of the medial group, and the difference was statistically significant (P P > 0.05). There were significant differences in HSS score and WOMAC score between the two groups at the last follow-up (P < 0.05). Conclusion: The lateral parapatellar approach can achieve better clinical results in the treatment of moderate and severe genu valva malformations. Compared with the medial parapatellar approach, the lateral parapatellar approach can provide better medial soft tissue tension balance, obtain good patellar trajectory, and shorten the operation time. Long-term follow-up of the lateral parapatellar approach can obtain higher knee functional scores, and experienced surgeons can be the first choice for the treatment of moderate and severe knee valvaration.
文摘目的评估微创前外侧肌间隙入路联合股骨颈保留在全髋关节置换术中的应用效果。方法回顾性分析2019年1月至2022年1月在渭南市第二医院接受全髋关节置换术的83例患者临床资料,其中42例采用微创前外侧肌间隙入路全髋关节置换术,并保留股骨颈,设为观察组;41例采用传统后外侧入路全髋关节置换术,设为对照组。观察组中男20例,女22例,年龄(63.75±6.76)岁;对照组中男23例,女18例,年龄(63.49±6.57)岁。比较两组患者的围手术期指标,术前和术后1 d的血清肌酸磷酸激酶(CPK)水平,术前和术后12个月的视觉模拟评分法(VAS)评分、髋关节Harris评分、Berg平衡量表(BBS)评分、步态参数、两侧肢体长度差、髋臼旋转中心的纵向及横向位移。采用t检验、χ^(2)检验。结果观察组患者的手术时间、术中出血量、切口长度、术后1 d引流量、术后1 d CPK水平分别为(60.26±7.41)min、(210.45±33.94)ml、(7.71±1.96)cm、(82.35±8.48)ml、(384.75±29.76)U/L,对照组分别为(68.97±8.35)min、(328.15±42.06)ml、(11.27±2.43)cm、(117.89±12.12)ml、(668.40±45.94)U/L,差异均有统计学意义(t=5.029、14.047、7.355、15.510、33.299,均P<0.001)。术后12个月,观察组的VAS评分、髋关节Harris评分、BBS评分、步频、最大步速、单足支撑时间百分比、足底压力差分别为(0.67±0.21)分、(90.45±9.37)分、(52.71±3.14)分、(96.79±8.12)步/min、(89.94±10.63)cm/s、(46.59±5.31)%、(9.02±1.03)%,对照组分别为(0.89±0.27)分、(82.63±8.04)分、(45.42±4.83)分、(81.14±7.59)步/min、(80.21±9.87)cm/s、(40.87±5.16)%、(10.61±2.12)%,差异均有统计学意义(t=4.137、4.084、8.131、9.074、4.323、4.977、4.329,均P<0.001)。影像学检查结果显示,观察组患者术后12个月的双侧肢体长差、纵向与横向的髋臼旋转中心位移均低于对照组(t=5.473、7.707、10.698,均P<0.001)。结论微创前外侧肌间隙入路联合股骨颈保留有助于全髋关节置换术后恢复,改善患者髋关节功能。
