CAJ | 학술논문

目的探讨全膝关节置换术后髌骨不稳的原因和预防措施.方法 1997年9月至2005年4月对94例(105膝)膝骨关节炎患者行全膝关节置换术.术前膝外翻14例,膝内翻80例,力线正常者11例.所用假体包括可旋转铰链型膝假体RK 10例14膝,活动衬垫型膝假体TACK 40例43膝,GEMINI假体44例48膝,所有患者均不置换髌骨.术前、术后在屈膝30°髌骨轴位片上测量髌骨的排列.结果术前有膝外翻和髌骨不稳者术后髌骨不稳的发生率分别为28.6%和29.5%,使用RK、TACK、GEMINI假体的患者髌骨不稳的发生率分别为28.6%,20.9%和16.7%.4例有明显股骨或胫骨假体旋转异常.结论膝关节置换术后出现髌骨不稳定的原因包括患者术前状态、假体设计、假体位置不良等.选择合适的假体,熟练掌握手术技巧,能明显减少膝关节置换术后髌骨轨迹异常.
목적 탐토전슬관절치환술후빈골불은적원인화예방조시.방법 1997년9월지2005년4월대94례(105슬)슬골관절염환자행전슬관절치환술.술전슬외번14례,슬내번80례,력선정상자11례.소용가체포괄가선전교련형슬가체RK 10례14슬,활동츤점형슬가체TACK 40례43슬,GEMINI가체44례48슬,소유환자균불치환빈골.술전、술후재굴슬30°빈골축위편상측량빈골적배렬.결과 술전유슬외번화빈골불은자술후빈골불은적발생솔분별위28.6%화29.5%,사용RK、TACK、GEMINI가체적환자빈골불은적발생솔분별위28.6%,20.9%화16.7%.4례유명현고골혹경골가체선전이상.결론 슬관절치환술후출현빈골불은정적원인포괄환자술전상태、가체설계、가체위치불량등.선택합괄적가체,숙련장악수술기교,능명현감소슬관절치환술후빈골궤적이상.
Objective To investigate the etiologies and prevention of patellar instability after total knee arthroplasty(TKA).Methods From September 1997 to April 2005,94 patients(105 knees)underwent TKA without patellar resurfacing.All of them were osteoarthritis.Ten patients(14 knees)were performed with Rotation Knee(RK)prostheses.Forty patients were performed with mobile bearing TACK prostheses,and 44 patients with GEMINI prostheses.Subluxation and tilt of patella were evaluated by X-rays before or after operation.Results The incidence of patellar instability aftet operation was 28.6% in patients who had genu valgus deformity,and was 29.5% in whom had patellar instability preoperative.The incidence of patellar instability in RK,TACK,and GEMINI group was 28.6%,20.9%,and 16.7% respectively after operations.Four patients had obvious femoral or tibial components malrotation.Conclusions The etiologies of patellofemoral instability include pre-operative conditions,prosthetic design,and improper positioning of the prosthetic component.So the suitable component design and skillful operative technique will help the surgeon to avoid this complication.