实用骨科杂志
實用骨科雜誌
실용골과잡지
JOURNAL OF PRACTICAL ORTHOPEDICS
2014年
10期
891-894
,共4页
全膝关节置换%测量截骨法%伸直优先截骨%力线
全膝關節置換%測量截骨法%伸直優先截骨%力線
전슬관절치환%측량절골법%신직우선절골%력선
total knee arthroplasty%measured osteotomy%extension first osteotomy%alignment
目的：探讨应用伸直间隙优先截骨法在全膝关节置换过程中应用及临床效果。方法对39例患者39膝（骨关节炎36例，类风湿关节炎3例）行人工膝关节表面置换术，应用LDK JOINT PS型假体。术中按术前测量外翻角度先进行股骨远端截骨，再根据胫骨髓外定位装置，行胫骨平台截骨，最后行股骨前后、斜面及髁间窝的截骨，髌骨不常规置换。记录手术时间，置换后引流量，置换前及置换后2，6周膝关节活动度，并进行统计学分析结果39例患者均获得随访，随访时间4~30个月，平均14个月。手术时间平均（118.3±30.4）min，置换后引流量平均（272.7±106.1）mL。置换后6、12周患者膝关节活动度及美国特种外科医院（ the hospital for special surgery，HSS）评分均较置换前明显改善（ P<0.05）。术后患者均未出现感染，未出现假体排异反应。结论伸直间隙优先截骨法在全膝关节置换过程中，减少重复截骨的发生率，显露清晰，操作简便，可以充分保证术后膝关节完全伸直，力线正确。
目的：探討應用伸直間隙優先截骨法在全膝關節置換過程中應用及臨床效果。方法對39例患者39膝（骨關節炎36例，類風濕關節炎3例）行人工膝關節錶麵置換術，應用LDK JOINT PS型假體。術中按術前測量外翻角度先進行股骨遠耑截骨，再根據脛骨髓外定位裝置，行脛骨平檯截骨，最後行股骨前後、斜麵及髁間窩的截骨，髕骨不常規置換。記錄手術時間，置換後引流量，置換前及置換後2，6週膝關節活動度，併進行統計學分析結果39例患者均穫得隨訪，隨訪時間4~30箇月，平均14箇月。手術時間平均（118.3±30.4）min，置換後引流量平均（272.7±106.1）mL。置換後6、12週患者膝關節活動度及美國特種外科醫院（ the hospital for special surgery，HSS）評分均較置換前明顯改善（ P<0.05）。術後患者均未齣現感染，未齣現假體排異反應。結論伸直間隙優先截骨法在全膝關節置換過程中，減少重複截骨的髮生率，顯露清晰，操作簡便，可以充分保證術後膝關節完全伸直，力線正確。
목적：탐토응용신직간극우선절골법재전슬관절치환과정중응용급림상효과。방법대39례환자39슬（골관절염36례，류풍습관절염3례）행인공슬관절표면치환술，응용LDK JOINT PS형가체。술중안술전측량외번각도선진행고골원단절골，재근거경골수외정위장치，행경골평태절골，최후행고골전후、사면급과간와적절골，빈골불상규치환。기록수술시간，치환후인류량，치환전급치환후2，6주슬관절활동도，병진행통계학분석결과39례환자균획득수방，수방시간4~30개월，평균14개월。수술시간평균（118.3±30.4）min，치환후인류량평균（272.7±106.1）mL。치환후6、12주환자슬관절활동도급미국특충외과의원（ the hospital for special surgery，HSS）평분균교치환전명현개선（ P<0.05）。술후환자균미출현감염，미출현가체배이반응。결론신직간극우선절골법재전슬관절치환과정중，감소중복절골적발생솔，현로청석，조작간편，가이충분보증술후슬관절완전신직，력선정학。
Objective To explore the clinical effect of the extension first osteotomy in the process of total knee athroplas-ty. Methods A retrospective study was performed for 39 cases. There were 36 cases of osteoarthritis,3 cases of rheumatoid ar-hritis. The LDK JOINT prosthesis were used for total knee arthroplasty. The distal femoral osteotomy was performed firstly ac-cording to the valgus angle measured preoperatively,and then the tibial plateau osteotmy was performed based on the tibial ex-tramedullary positioning device. Patella was not routine replacement. Last we performed oblique osteotomy anterior and posterior to the distal femur( contained intercondylar osteotomy). The operation time,postoperative drainage volume,range of motion of knee joint as well as Hospital for Special Surgery knee scores before replacement and 2 and 6 weeks after replacement were re-corded and statistically analyzed. Results All the 39 patients were followed up for 3 to 14 months. The average operation time was(118. 3±30. 4)minutes;the postoperative drainage volume was(272. 7±106. 1)mL. The range of motion of knee joint and Hospital for Special Surgery knee scores 2 and 6 weeks after replacement were improved compared with those before re-placement(P<0. 05). There was no infection,no prosthesis rejection. Conclusion That the improved osteotomy can make the bone cutting more accurate,and reduce the chance and risk of osteotomy repeatedly. This method has the advantages of simple operation,shortening the operation time,reducing the intraoperative blood loss,protecting the surrounding soft tissue safely,en-suring the postoperative totally extend knee and better limb alignment.
