CAJ | 학술논문

目的探讨股内侧肌下入路行初次全膝关节置换术(total knee arthroplasty,TKA)的优点、风险及技术要点. 方法选择2008年9月-2010年8月基础条件相似的68例行TKA患者作为研究对象,采用股内侧肌下入路34例(A组),采用传统内侧髌旁入路34例(B组),比较两组临床参数指标. 结果 68例均获随访,时间6 ～ 25个月,平均8.7个月.两组患者均获得准确的力线对位,A组患者术后引流量为(124.0±32.4) ml,较B组的(182.0±41.3) ml低(P＜0.05).A组需做外侧支持带松解的比例为7％,较B组的23％减少(P＜0.01).A组患者能较早进行主动直腿抬高运动[A组为(1.3±0.7)d,B组为(3.2±0.6)d,(P＜0.05)]和屈曲到90°[A组为(3.1±0.6)d,B组为(5.3±0.5)d,(P＜0.05)]. 结论股内侧肌下入路行初次TKA对伸膝装置无显著干扰,对髌骨周围地血运破坏较少,术后膝关节功能恢复较快,早期疗效满意.
목적 탐토고내측기하입로행초차전슬관절치환술(total knee arthroplasty,TKA)적우점、풍험급기술요점. 방법 선택2008년9월-2010년8월기출조건상사적68례행TKA환자작위연구대상,채용고내측기하입로34례(A조),채용전통내측빈방입로34례(B조),비교량조림상삼수지표. 결과 68례균획수방,시간6 ～ 25개월,평균8.7개월.량조환자균획득준학적력선대위,A조환자술후인류량위(124.0±32.4) ml,교B조적(182.0±41.3) ml저(P＜0.05).A조수주외측지지대송해적비례위7％,교B조적23％감소(P＜0.01).A조환자능교조진행주동직퇴태고운동[A조위(1.3±0.7)d,B조위(3.2±0.6)d,(P＜0.05)]화굴곡도90°[A조위(3.1±0.6)d,B조위(5.3±0.5)d,(P＜0.05)]. 결론 고내측기하입로행초차TKA대신슬장치무현저간우,대빈골주위지혈운파배교소,술후슬관절공능회복교쾌,조기료효만의.
Objective To investigate technical points,risks and advantages of primary total knee arthroplasty (TKA) through subvastus approach.Methods The study involved 68 patients of similar basic conditions who were treated by TKA between September 2008 and August 2010,including 34 patients treated through subvastus approach (Group A) and 34 patients treated through traditional medial parapatella approach (Group B).Clinical parameters between groups were comparatively studied after operation.Results All patients were followed up for 6-25 months (mean 8.7 months).Alignment of lower extremities in both groups was restored.Group A showed significant differences from Group B in aspects of postoperative drainage volume [(124 ± 32.4) ml vs (182 ± 41.3) ml,P ＜ 0.05],requirement of lateral retinacular release (7％ vs 23％,P ＜0.01),time before patients being capable of having active straight-leg-raising movement [(1.3 ± 0.7) d vs (3.2 ± 0.6) d,P ＜ 0.05],and time away from patients being able to bend their leg up to 90° [(3.1 ± 0.6) d vs (5.3 ± 0.5) d,P ＜ 0.05].Conclusion Primary total knee arthroplasty through subvastus approach can hardly intervene in extension knee apparatus and in blood circulation around patellas,promote rapid recovery of knee function and achieve satisfactory early outcomes.