CAJ | 학술논문

目的：探讨深盘型假体对全膝关节置换初期疗效的影响。方法2006年6月～2012年1月，本组应用深盘型垫片假体行TKA的76例（97膝）患者进行随访，随访时间2～6年，平均4．2年，其中女65例，男11例；年龄55～78岁，平均65．8岁；选择男女共76名志愿者，年龄在18～42岁之间，平均30．5岁，随机左右膝。对比TKA组术前、术后KSS评分、功能评分、膝关节ROM、股骨后髁偏心距；对比TKA组与志愿者组膝关节从伸直位到最大屈曲位时股骨相对于胫骨前后移动的距离。结果 TKA组手术前后膝关节KSS评分、功能评分及膝关节ROM比较，差异均有统计学意义（ P＜0.05），手术前后股骨后髁偏心距差异无统计学意义（ P＞0.05）。 TKA组膝关节从伸直位到最大屈曲位时股骨相对于胫骨向后移动距离之差（6.24±2.45） mm。志愿者组膝关节伸直至最大屈曲位时股骨相对于胫骨向后移动距离之差（10.87±1.49） mm，两者差异有统计学意义（ P＜0.05）。1例术后出现伤口浅表感染，经处理后痊愈。1例术后出现膝关节假体周围感染，经二期翻修痊愈出院。术后随访X线片观察膝关节假体位置、力线、固定性能等均显示良好，无松动、透亮线等异常表现。结论使用深盘型膝关节假体行TKA术，初期临床疗效满意；TKA组术后膝关节伸直至最大屈曲位时股骨相对于胫骨后移距离较志愿者组短。
목적：탐토심반형가체대전슬관절치환초기료효적영향。방법2006년6월～2012년1월，본조응용심반형점편가체행TKA적76례（97슬）환자진행수방，수방시간2～6년，평균4．2년，기중녀65례，남11례；년령55～78세，평균65．8세；선택남녀공76명지원자，년령재18～42세지간，평균30．5세，수궤좌우슬。대비TKA조술전、술후KSS평분、공능평분、슬관절ROM、고골후과편심거；대비TKA조여지원자조슬관절종신직위도최대굴곡위시고골상대우경골전후이동적거리。결과 TKA조수술전후슬관절KSS평분、공능평분급슬관절ROM비교，차이균유통계학의의（ P＜0.05），수술전후고골후과편심거차이무통계학의의（ P＞0.05）。 TKA조슬관절종신직위도최대굴곡위시고골상대우경골향후이동거리지차（6.24±2.45） mm。지원자조슬관절신직지최대굴곡위시고골상대우경골향후이동거리지차（10.87±1.49） mm，량자차이유통계학의의（ P＜0.05）。1례술후출현상구천표감염，경처리후전유。1례술후출현슬관절가체주위감염，경이기번수전유출원。술후수방X선편관찰슬관절가체위치、력선、고정성능등균현시량호，무송동、투량선등이상표현。결론사용심반형슬관절가체행TKA술，초기림상료효만의；TKA조술후슬관절신직지최대굴곡위시고골상대우경골후이거리교지원자조단。
Objective To explore the effect of the deep disc prosthesis on the early curative effect of the total knee arthroplasty (TKA).Methods From June 2006 to January 2012, in our hospital, 76 cases of deep-disc type spacer prosthesis TKA (97 knees) were followed up.The follow-up time was 2-6 years, 4.2 years in average, including 65 females and 11 males.The age was from 55 to 78 years old, 65. 8 years in average.There were 76 healthy volunteers, aged from 18 to 42 years old, 30.5 years in average, who were randomly chosen for the right or left knee as control .The preoperative and postoperative KSS score, knee joint function score, ROM knee, and the posterior condylar offset of the TIKA group were compared.compared with TKA group and volunteer groups of the tibia shifting distance of the TKA group and volunteer group was compared .The femoral translation during the knee position changed from extension to the maximum flexion was compared between the TKA group and the volunteer group .Results The differences in KSS score , knee joint function score , and ROM of the TKA group before and after operation were statistically significant ( P<0.05 ) , while there was no significant difference in the difference of the posterior condylar offset before and after the surgery ( P>0.05 ) .The femoral translation during the knee position changed from extension to the maximum flexion was (6.24 ±2.45) mm in the TKA group, and the distance was (10.87 ±1.49) mm in the volunteer group , the difference was statistically significant ( P<0.05 ) .There was superficial wound infection in one case , and it was cured after the treatment .There was one case of the periprosthesis infection , which was healed after the second stage revision .Postoperative follow-up X-ray imaging showed that the prosthesis position , force lines, and the fixation performance were good, and there was no loosening , radiolucent lines and other abnormalities .Conclusion The use of deep disc prosthesis in TKA provides a satisfactory initial clinical curative effect; the femoral translation during the knee position changes was smaller in the TKA group than the volunteer group .