CAJ | 학술논문

背景：人工膝关节翻修术后的关节线位置是影响术后效果的重要因素之一。 　　目的：探讨人工膝关节翻修手术技术对关节线位置改变的影响及其原因。 　　方法：回顾性分析2012年1月至2012年12月行人工膝关节翻修手术的31例患者的X线片资料及临床资料，测量术前、术后关节线的位置，分析关节线位置改变情况与股骨前后径变化和是否使用股骨远端金属加强垫块的关系。 　　结果：本组患者人工膝关节翻修术后关节线位置较术前平均改变（1.2±3.4）mm（-4.0~8.7 mm）；关节线位置改变情况与股骨前后径变化呈线性相关；使用与未使用股骨远端金属加强垫块患者的关节线位置较术前平均改变（-0.54±2.39）mm和（2.59±3.55）mm，均有统计学差异（P＜0.01），使用股骨远端金属加强垫块能更精确重建关节线。 　　结论：目前，人工膝关节翻修手术技术可以重建膝关节关节线，但需要注意股骨大小的重建和骨缺损的处理。
배경：인공슬관절번수술후적관절선위치시영향술후효과적중요인소지일。 　　목적：탐토인공슬관절번수수술기술대관절선위치개변적영향급기원인。 　　방법：회고성분석2012년1월지2012년12월행인공슬관절번수수술적31례환자적X선편자료급림상자료，측량술전、술후관절선적위치，분석관절선위치개변정황여고골전후경변화화시부사용고골원단금속가강점괴적관계。 　　결과：본조환자인공슬관절번수술후관절선위치교술전평균개변（1.2±3.4）mm（-4.0~8.7 mm）；관절선위치개변정황여고골전후경변화정선성상관；사용여미사용고골원단금속가강점괴환자적관절선위치교술전평균개변（-0.54±2.39）mm화（2.59±3.55）mm，균유통계학차이（P＜0.01），사용고골원단금속가강점괴능경정학중건관절선。 　　결론：목전，인공슬관절번수수술기술가이중건슬관절관절선，단수요주의고골대소적중건화골결손적처리。
Background:The position of the joint line is one of the important parameters to evaluate the outcome of knee revision. Objective:To analyze the effect of surgical technique of knee revision on the joint line variance. Methods:A retrospective analysis was conducted in 31 patients undergoing total knee revision between January 2012 and December 2012. Preoperative and postoperative joint lines were measured. The correlation between the change of joint line and the distal femur anterior posterior dimension and the use of distal femur metal augment were analyzed. Results: The overall change of the knee joint line was (1.2 ± 3.4)mm (-4.0~8.7 mm) compared to the preoperative ones. There was linear correlation between the position of knee joint and distal femur anterior posterior dimension. The change of the knee joint line was (-0.54±2.39)mm and (2.59±3.55)mm with and without use of distal femur metal augment after sur-gery (P<0.01). Conclusions:The knee joint line can be reconstructed by total knee revision, but more attention should be paid to the distal femur anterior posterior dimension and the bone defect.