军事医学
軍事醫學
군사의학
BULLETIN OF THE ACADEMY OF MILITARY MEDICAL SCIENCES
2014年
7期
547-549
,共3页
彭伟%黄迅悟%王海山%孟祥亮
彭偉%黃迅悟%王海山%孟祥亮
팽위%황신오%왕해산%맹상량
股胫角%胫骨%截骨术%关节成形术,置换,膝%膝关节,人工
股脛角%脛骨%截骨術%關節成形術,置換,膝%膝關節,人工
고경각%경골%절골술%관절성형술,치환,슬%슬관절,인공
femorotibial angle%tibia%osteotomy%arthroplasty,repalcement,knee%knee prosthesis
目的：对胫骨高位截骨失败后转行人工全膝关节置换的疗效进行分析，以探讨影响治疗结果的因素。方法2000～2010年对16例（19膝）胫骨高位截骨失败患者施行人工全膝关节置换术，手术前、后采用美国膝关节协会评分（ KSS评分）标准对结果进行分析，并比较股胫角、Q角、胫骨平台后倾角和膝关节活动度（ ROM ）。结果依据KSS评分标准，膝关节评分由术前（73．20±3．56）分提高到术后（153．00±3．39）分；股胫角由术前160．57°±3．30°矫正为术后169．85°±1．34°；Q角由术前24．57°±2．07°矫正为术后17．28°±1．11°；胫骨平台后倾角由术前2．25°±0．50°矫正为3．75°±0．95°；Insall-Salvatti比由术前0．80±0．08矫正到术后1．05±0．12；膝关节ROM由术前38．25°±8．88°提高到术后96．25°±4．34°（ P＜0．05）。结论胫骨高位截骨失败后转行人工全膝关节置换的手术需要适当的软组织平衡、正确的下肢力线和选择合适的假体。
目的：對脛骨高位截骨失敗後轉行人工全膝關節置換的療效進行分析，以探討影響治療結果的因素。方法2000～2010年對16例（19膝）脛骨高位截骨失敗患者施行人工全膝關節置換術，手術前、後採用美國膝關節協會評分（ KSS評分）標準對結果進行分析，併比較股脛角、Q角、脛骨平檯後傾角和膝關節活動度（ ROM ）。結果依據KSS評分標準，膝關節評分由術前（73．20±3．56）分提高到術後（153．00±3．39）分；股脛角由術前160．57°±3．30°矯正為術後169．85°±1．34°；Q角由術前24．57°±2．07°矯正為術後17．28°±1．11°；脛骨平檯後傾角由術前2．25°±0．50°矯正為3．75°±0．95°；Insall-Salvatti比由術前0．80±0．08矯正到術後1．05±0．12；膝關節ROM由術前38．25°±8．88°提高到術後96．25°±4．34°（ P＜0．05）。結論脛骨高位截骨失敗後轉行人工全膝關節置換的手術需要適噹的軟組織平衡、正確的下肢力線和選擇閤適的假體。
목적：대경골고위절골실패후전행인공전슬관절치환적료효진행분석，이탐토영향치료결과적인소。방법2000～2010년대16례（19슬）경골고위절골실패환자시행인공전슬관절치환술，수술전、후채용미국슬관절협회평분（ KSS평분）표준대결과진행분석，병비교고경각、Q각、경골평태후경각화슬관절활동도（ ROM ）。결과의거KSS평분표준，슬관절평분유술전（73．20±3．56）분제고도술후（153．00±3．39）분；고경각유술전160．57°±3．30°교정위술후169．85°±1．34°；Q각유술전24．57°±2．07°교정위술후17．28°±1．11°；경골평태후경각유술전2．25°±0．50°교정위3．75°±0．95°；Insall-Salvatti비유술전0．80±0．08교정도술후1．05±0．12；슬관절ROM유술전38．25°±8．88°제고도술후96．25°±4．34°（ P＜0．05）。결론경골고위절골실패후전행인공전슬관절치환적수술수요괄당적연조직평형、정학적하지력선화선택합괄적가체。
Objective To investigate the effect of total knee arthroplasty ( TKA) following high tibial osteotomy ( HTO) and to analyze the factors that may influence the operation .Methods A total of 16 patients (19 knees) who had undergone a previous HTO were treated with TKA between 2000 and 2010.The American Knee Society Scores ( KSS), femorotibial angle ,quadriceps angle ,posterior slope angle of tibial plateau ,Insall Salvatti Ratio and knee range of motion ( ROM) were evaluated for each patient pre-and post-operatively and the results were evaluated .Results The KSS scores improved from 73.20 ±3.56 scores preoperatively to 153.00 ±3.39 scores postoperatively (P <0.05).The femorotibial angle was corrected from 160.57°±3.30°preoperatively to 169.85°±1.34°postoperatively(P<0.05).The quadriceps angle was corrected from 24.57°±2.07°preoperatively to 17.28°±1.11°postoperatively (P<0.05).The posterior slope angle of tibial plateau was corrected from 2.25°±0.50°preoperatively to 3.75°±0.95°postoperatively (P<0.05).The Insall Salvatti Ratio improved from 0.80 ±0.08 preoperatively to 1.05 ±0.12 postoperatively ( P <0.05).The knee ROM improved to 38.25°±8.88°postoperatively from 96.25°±4.34°preoperatively(P<0.05).Conclusion TKA following HTO demands adequate soft tissue balancing , good limb alignment and appropriate prosthesis .
