CAJ | 학술논문

背景：全膝关节置换术（total knee arthroplasty，TKA）已成为治疗膝骨关节炎（osteoarthritis of the knee，OA）的有效方法。但在治疗满意度上，男女之间差别较大。 　　目的：比较采用Gender Solutions Nex-Gen膝关节假体与普通高屈曲度假体治疗女性膝骨关节炎的近期临床疗效。 　　方法：2008年3月至2011年11月，55例（79膝）女性OA患者接受全膝关节表面置换手术。A组：24例37膝，采用Gen-der Solutions Nex-Gen膝关节假体（美国Zimmer公司）；B组：31例42膝，采用普通高屈曲度假体（美国Zimmer公司）治疗。对比两组手术并发症、KOOS (Knee injury and Osteoarthritis Outcome Score)评分、主观满意指数（satisfaction in-dex，SI）、膝关节活动度、膝关节最大屈曲度、膝前疼痛发生率。 　　结果：55例患者中4例失访，平均随访35.2个月（24~50个月），KOOS各项评分两组间比较无统计学意义（P>0.05)，但组内比较均有统计学意义（P<0.01）。组间及组内膝关节活动度、最大屈曲度比较差异均有统计学意义（P<0.01）。组间主观满意度比较有统计学意义（P<0.01）。A组下肢静脉血栓1例，给予抗凝治疗后痊愈；B组膝关节浅度感染1例，膝前反复痛7例，两组膝前疼痛率比较有统计学意义（P<0.05）。两组病例无膝关节僵直、神经血管损伤、假体松动。 　　结论：Gender Solutions Nex-Gen与普通高屈曲度假体均能有效治疗女性膝骨关节炎，但Gender Solutions Nex-Gen膝关节假体符合女性膝关节解剖，满意度、临床疗效更高。
배경：전슬관절치환술（total knee arthroplasty，TKA）이성위치료슬골관절염（osteoarthritis of the knee，OA）적유효방법。단재치료만의도상，남녀지간차별교대。 　　목적：비교채용Gender Solutions Nex-Gen슬관절가체여보통고굴곡도가체치료녀성슬골관절염적근기림상료효。 　　방법：2008년3월지2011년11월，55례（79슬）녀성OA환자접수전슬관절표면치환수술。A조：24례37슬，채용Gen-der Solutions Nex-Gen슬관절가체（미국Zimmer공사）；B조：31례42슬，채용보통고굴곡도가체（미국Zimmer공사）치료。대비량조수술병발증、KOOS (Knee injury and Osteoarthritis Outcome Score)평분、주관만의지수（satisfaction in-dex，SI）、슬관절활동도、슬관절최대굴곡도、슬전동통발생솔。 　　결과：55례환자중4례실방，평균수방35.2개월（24~50개월），KOOS각항평분량조간비교무통계학의의（P>0.05)，단조내비교균유통계학의의（P<0.01）。조간급조내슬관절활동도、최대굴곡도비교차이균유통계학의의（P<0.01）。조간주관만의도비교유통계학의의（P<0.01）。A조하지정맥혈전1례，급여항응치료후전유；B조슬관절천도감염1례，슬전반복통7례，량조슬전동통솔비교유통계학의의（P<0.05）。량조병례무슬관절강직、신경혈관손상、가체송동。 　　결론：Gender Solutions Nex-Gen여보통고굴곡도가체균능유효치료녀성슬골관절염，단Gender Solutions Nex-Gen슬관절가체부합녀성슬관절해부，만의도、림상료효경고。
Background:Total knee arthroplasty (TKA) has been an effective treatment for osteoarthritis of knee (OA). However, there is significant difference in patients' satisfaction between male and female patients. Objective:To compare the short-term clinical outcomes of TKA with Gender Knee versus High-flex LPS Knee in female OA patients. Methods:A total of 55 female OA patients (79 knees) treated by TKA from March 2008 to November 2011 were enrolled in the retrospective study. Gender Knee prosthesis (Zimmer Co.) was applied in 24 cases (37 knees, group A) and High Flex LPS (Zimmer Co.) was used in 31 cases (42 knees, group B). Surgical complications, KOOS (Knee injury and Osteoarthritis Outcome Score), satisfaction index of patients, knee range of motion, knee maximum flexion and anterior knee pain were compared between two groups. Results:Fifty-one patients were followed up with a mean duration of 35.2 months (range, 24-50 months). There were no sig-nificant differences in KOOS scores between two groups (P>0.05). Compared with preoperative ones, postoperative KOOS scores, knee range of motion, and knee maximum flexion were significantly increased in all patients (P<0.01). Moreover, knee range of motion, knee maximum flexion and satisfaction index of patients in the patients with Gender Knee were sig-nificantly greater than those in the patients with High-flex LPS knee (P<0.01). Complications included one deep venous thrombosis in group A, one infection and seven anterior knee pain in group B. No knee joint stiffness, injury of blood vessel and nerve and prosthesis loosening occurred during follow up. Conclusions:Both Gender Knee and High-flex LPS can effectively treat osteoarthritis in women. But Gender knee has a bet-ter matching anatomy in women with higher satisfactory index and better clinical outcome.