CAJ | 학술논문

目的对膝关节外翻畸形患者进行术前个体化分析以及术中个体化软组织平衡技术，观察人工全膝关节置换术后的临床疗效及术后随访结果分析。方法对14例（17膝）膝关节外翻畸形患者行人工全膝关节置换术，其中男3例，女11例，年龄55~78岁，平均65.3岁。术前进行个体化影像学分析，以及术中个体化的软组织平衡技术，对患者进行术后随访检查膝关节活动度，X射线检测膝外翻角度及HSS评分评价手术效果。结果17例均得到随访，随访时间平均33个月(12个月~60个月)。术前测量膝外翻角度为（14.7依7.9）゜，术后为（4.6依2.5）゜；活动范围术前平均（71.5依16.7）゜，术后为（113.6依17.8）゜；术前HSS膝关节评分(38.20依12.32)分，置换后为（85.83依9.34）分。置换前后比较采用配对t检验，差异具有统计学意义（<0.05）。其中1例患者术后出现膝关节外侧疼痛，予保守治疗后症状好转。结论通过膝外翻患者行人工全膝关节置换术的中期随访结果进行分析，证实人工全膝关节置换术前个体化分析、术中个体化的软组织平衡技术有助于取得较满意的临床效果。
목적대슬관절외번기형환자진행술전개체화분석이급술중개체화연조직평형기술，관찰인공전슬관절치환술후적림상료효급술후수방결과분석。방법대14례（17슬）슬관절외번기형환자행인공전슬관절치환술，기중남3례，녀11례，년령55~78세，평균65.3세。술전진행개체화영상학분석，이급술중개체화적연조직평형기술，대환자진행술후수방검사슬관절활동도，X사선검측슬외번각도급HSS평분평개수술효과。결과17례균득도수방，수방시간평균33개월(12개월~60개월)。술전측량슬외번각도위（14.7의7.9）゜，술후위（4.6의2.5）゜；활동범위술전평균（71.5의16.7）゜，술후위（113.6의17.8）゜；술전HSS슬관절평분(38.20의12.32)분，치환후위（85.83의9.34）분。치환전후비교채용배대t검험，차이구유통계학의의（<0.05）。기중1례환자술후출현슬관절외측동통，여보수치료후증상호전。결론통과슬외번환자행인공전슬관절치환술적중기수방결과진행분석，증실인공전슬관절치환술전개체화분석、술중개체화적연조직평형기술유조우취득교만의적림상효과。
Objective To investigate and analyze the mid-term follow-up results of total knee arthroplasty (TKA) for valgus knees, that using individual pre-operative imaging analysis and intra-operative soft tissue balance technique.Methods A consecutive series of 17 cases in 14 patients with valgus knees were treated with TKA.There were 9 females and 2 males, and the mean age of the patient at the time of surgery was 65.3 years (range from 55~78 years). Before the operation, the detailed pre-operative imaging analysis was needed, and intra-operative soft tissue balance technique was used. Each patient was evaluated by Harris hip score , physical examination and radiographic results.Results The mean fol ow-up was 33 months (range, 12~60 months),The mean HHS was 44.20±19.51 preoperatively and 44.20±19.51 at the last visit ( <0.05).The mean amount of pre-operative tibial and femur angle(FTA) Was(71.5±16.7)゜, post-operative FTA was(113.6±17.8)゜.range of motion was improved from(71.5±16.7)゜ to(113.6±17.8)゜.The average HSS scores increased from preoperative 38.20±12.32 to postoperative 85.83±9.34. Pre-operative and post-operative changes were significantly dif erent ( <0.01). Lateral knee pain was detected in 1 knee postoperatively, which was healed after 3 months' symptomatic treatment. Conclusion Mid-term results shows, TKA that using individual pre-operative imaging analysis and intra-operative soft tissue balance technique, is an ef ective procedure for valgus knee.