摘要
背景:全膝置换术(totalkneearthroplasty,TKA)中熟练掌握胫骨假体置放的正确位置,是术后患者膝关节功能恢复的重要影响因素。目的:探讨人工全膝关节置换术中胫骨假体放置的点、线、面定位及其相互关系,以提高手术后患肢膝关节功能和关节稳定性。设计:前后对照研究。单位:一所大学医院骨科的病房。对象:1999-05/2004-09徐州医学院附属医院骨科收治的严重骨关节病及类风湿性关节炎需行膝关节置换患者12例,男4例,女8例;双侧膝置换1例,单侧置换11例;左膝关节4个,右膝关节9个。方法:按标准手术方法手术,着重胫骨假体的放置兼顾点、线、面定位及其相互关系。于手术前后进行膝关节侧方稳定性评估和HSS膝关节功能系统评价。主要观察指标:①患者手术前后膝关节侧方稳定性。②膝关节功能系统评分包括疼痛、功能、活动范围、肌力、屈曲畸形和稳定性。③X射线()观察结果。结果:12例按照Knee-Society-Scores标准KSS系统评价,术前轻度侧方不稳3例,中度不稳7例,严重不稳2例;术后仅轻度侧方不稳1例,中重度不稳者未见。按照HSS系统评价术前评分平均为41分,术后随访时评分平均为89分,术后优良率达91.7%(11/12)。结论:TKA注意胫骨假体的点、线、面定位及其相互关系,可以增强膝关节稳定性,明显改善患者疼痛、关节功能及关节?
BACKGROUND:The proper placement of the prosthesis during total knee arthropla sty(TKA) is a key factor that will affect the restored function of the knee. OBJECTIVE:To probe into the position and axial alignment of the tibial prosth esis in order to improve knee function and stability after TKA. DESIGN:A self control study. SETTING:Orthopaedic department in the affiliated hospital of a university. PARTICIPANTS:A total of 12 patients(4 males and 8 females) received TKA due t o severe osteoarthropathy or rheumatic arthritis in the Orthopaedic Department o f the Affiliated Hospital,Xuzhou Medical College,from May 1999 to September 2004 .One received bilateral TKA and 11 received unilateral TKA(4 in the left knee an d 9 in the right knee). METHODS:TKA was performed in standard procedure and special attention was pai d to the proper placement of the tibial prosthesis.Evaluation on lateral genual stability and HSS knee function was made before and after operation. MAIN OUTCOME MEASURES:①Lateral genual stability before and after TKA.②Genua l function scale( concerning pain,function,range of motion,muscle strength,flexi on deformity and stability).③X ray observation. RESULTS:Knee Society Scores were evaluated in the 12 patients. Before TKA,3 knees had mild lateral instability,7 moderates and 2 severe instabilitys.After TKA,only one knee was mildly unstable and no knee had moderate or severe instabi lity.The mean scores of HSS scale increased from 41 before operation to 89 after operation with the effective rate of 91.7%(11/12). CONCLUSION:The precise placement of tibial prosthesis can increase stability of the knee and relieve pain as well as improve knee function and motion.
出处
《中国临床康复》
CSCD
北大核心
2005年第2期220-222,共3页
Chinese Journal of Clinical Rehabilitation
