摘要
背景:股骨假体旋转不良可造成屈曲间隙不平衡和髌骨轨迹不良,从而影响膝关节功能的恢复。目的:观察全膝关节置换股骨假体旋转角对患者膝关节评分的影响。方法:选取2010年1月至2014年1月在江苏镇江市第一人民医院关节外科行初次全膝关节置换的患者146例(186膝)。置换后进行CT扫描检查并测量股骨髁扭转角评价股骨假体旋转位置,根据股骨髁扭转角分为3组,正常组74例(外旋3°-内旋3°),内旋组15例(内旋>3°),外旋组58例(外旋>3°),置换后随访3年。结果与结论:①膝关节美国膝关节协会评分:正常组活动功能评分明显高于内旋组和外旋组,外旋组活动功能评分高于内旋组(P<0.05);在活动功能评分中3组的标准活动评分、自由活动评分及高级活动评分中,正常组明显高于内旋组和外旋组,外旋组高于内旋组(P<0.05);但3组的站立与行走评分、满意度评分和期望评分比较差异无显著性意义;②结果证实:股骨假体旋转角影响全膝关节置换后远期膝关节功能恢复,因此应注意避免置换中股骨假体旋转不良。
BACKGROUND： Femoral prosthesis malrotation will lead to various complications, such as femoro-tibial and patellofemoral instability, and maladjustment of patellar movement trajectory, further affecting the recovery of the knee function.OBJECTIVE： To evaluate the influence of the rotation angle of the femoral prosthesis on the knee joint function after total knee arthroplasty （TKA）.METHODS： Totally 146 patients （186 knees） undergoing TKA in the Department of Joint Surgery, Zhenjiang First People＇s Hospital from January 2010 to January 2014 were selected. Afterwards, the femoral condyle torsion angle was measured on CT to evaluate the rotational position of the femoral prosthesis. According to the condyle torsion angle, all the patients were divided into three groups： normal group （n=74, extorsion angle 3°-intorsion angle 3°）, intorsion group （n=15, intorsion angle 〉 3°） and group （n=58, extorsion angle 〉 3°）. All the patients were followed up for 3 years.RESULTS AND CONCLUSION： （1） The order of the activity function score was as follows： the normal group 〉 extorsion group 〉 intorsion group （P 〈 0.05）. The standard activity, free activity and senior activity scores were highest in the normal group, followed by the extorsion group, and lowest in the intorsion group （P 〈 0.05）. However, the standing and walking scores, as well as the satisfaction and expected scores did not differ significantly among groups. （2） That is to say, the rotational position of the femoral prosthesis influences the long-term knee joint function after TKA, so we should pay attention to the femoral prosthesis malrotation.
出处
《中国组织工程研究》
CAS
北大核心
2017年第27期4283-4287,共5页
Chinese Journal of Tissue Engineering Research
基金
国家自然科学基金(81270011)~~
