CAJ | 학술논문

目的探讨后稳型旋转平台高屈曲假体膝关节置换的手术适应证及其在改善膝关节功能方面的优越性.方法应用前瞻性随机对照研究方法,将2009年2月至2009年4月经门、急诊收治的膝关节骨关节炎患者75例94膝随机分为两组,一组接受后稳型旋转平台普通假体置换(PFC sigma RP假体),另一组接受后稳型旋转平台高屈曲假体置换(PFC sigma RPF假体).两组患者的一般情况及术前特种外科医院(the Hospital for Special Surgery,HSS)膝关节评分和膝关节活动范围差异均无统计学意义.根据患者入院顺序再次随机化,由3名术者抽签决定各自的手术对象.术后1、6、12及18个月复查HSS评分及膝关节活动范围,术后18个月对患者进行满意度问卷调查.所有患者术前、术后第3天、3、6、12和18个月拍摄术侧膝关节正、侧位和双下肢站立位全长X线片.结果 70例87膝完成最终随访,普通组33例46膝,高屈曲组34例41膝.术后18个月普通组HSS膝关节评分(92.4±5.0)分,高屈曲组(94.7±7.0)分,两组差异无统计学意义;普通组膝关节活动范围123.0°±15.3°,高屈曲组131.9°±14°,两组差异有统计学意义,高屈曲组大于普通组,但未达到样本量估计时所设定的20°.术后18个月,两组患者的手术满意率均为100%.结论高屈曲假体与普通假体置换的近期疗效相似.高屈曲假体未显示出在膝关节屈曲活动范围方面的优势.
목적 탐토후은형선전평태고굴곡가체슬관절치환적수술괄응증급기재개선슬관절공능방면적우월성.방법 응용전첨성수궤대조연구방법,장2009년2월지2009년4월경문、급진수치적슬관절골관절염환자75례94슬수궤분위량조,일조접수후은형선전평태보통가체치환(PFC sigma RP가체),령일조접수후은형선전평태고굴곡가체치환(PFC sigma RPF가체).량조환자적일반정황급술전특충외과의원(the Hospital for Special Surgery,HSS)슬관절평분화슬관절활동범위차이균무통계학의의.근거환자입원순서재차수궤화,유3명술자추첨결정각자적수술대상.술후1、6、12급18개월복사HSS평분급슬관절활동범위,술후18개월대환자진행만의도문권조사.소유환자술전、술후제3천、3、6、12화18개월박섭술측슬관절정、측위화쌍하지참립위전장X선편.결과 70례87슬완성최종수방,보통조33례46슬,고굴곡조34례41슬.술후18개월보통조HSS슬관절평분(92.4±5.0)분,고굴곡조(94.7±7.0)분,량조차이무통계학의의;보통조슬관절활동범위123.0°±15.3°,고굴곡조131.9°±14°,량조차이유통계학의의,고굴곡조대우보통조,단미체도양본량고계시소설정적20°.술후18개월,량조환자적수술만의솔균위100%.결론 고굴곡가체여보통가체치환적근기료효상사.고굴곡가체미현시출재슬관절굴곡활동범위방면적우세.
Objective To explore the indication and the functional advantages of the high-flexion posterior stabilized (PS) rotating-platform mobile-bearing (RP-MB) total knee system. Methods A prospective randomized, controlled trial was performed. Osteoarthritis was the indicators for total knee arthroplasty.From Feb. 2009 to Apr. 2009, 75 patients (94 knees) were randomly assigned to to receive either a highflexion PS, RP-MB total knee system(PFC sigma RPF) or a standard one (PFC sigma RP). There were no statistical difference in the baselines, the preoperative scores of the Hospital for Special Surgery (HSS) and the knee range of motion (ROM) of both groups. The functional status were assessed with Hospital for Special Surgery and the ROM of the knee at the postoperative 1, 6, 12, 18 months. The satisfaction rates were assessed at the postoperative 18 months. The radiographic measurements were t assessed at the postoperative 3days and 3, 6, 12, 18 months. Results A total of 70 participants (87 knees) completed the 18-month followup. At the time of the final follow-up, the average Hospital for Special Surgery knee score was 92.4±5.0points in the standard group and 94.7±7.0 points in the high-flex ion group. The difference was not statistically significant(P ＞0.05). The average maximal flexion was 131.9±14 degrees in the high-flexion group and 123.0±15.3 degrees in the standard group. There was a statistical difference. But it was not enough to confirm our hypothesis that the difference should be higher than 10 degrees. Moreover, the satisfaction rate were 100% in both groups, and no statistical significant difference was found. Conclusion No significant differences were found between standard and high-flexion posterior-stabilized rotating-platform mobile-bearing total knee prostheses in terms of clinical outcomes or range of motion.