CAJ | 학술논문

目的分析髁限制性假体在复杂初次膝关节置换以及膝关节翻修手术中的应用经验,总结髁限制性假体使用的适应证及临床效果.方法2002年7月至2009年1月采用髁限制性假体治疗膝关节骨性关节炎15例(17膝),其中膝关节内翻患者7例(8膝),膝关节外翻患者5例(6例),膝关节翻修3例.所有患者均使用假体延长柄,并采用骨水泥固定延长杆.手术前后对患膝进行Hss评分,对患者进行满意度调查.记录膝关节的屈伸范围及并发症情况,膝关节X线情况来评估手术临床效果.结果平均随访24个月(14~72个月),出院时所有患者疼痛消失,关节稳定,力线纠正,末次随访时膝关节屈伸活动范围由术前(58.9±18.8°),提高到术后(100.3±5.3°).Hss评分从术前(38.1±17)分,提高到术后的(80.78±7.6)分,术前、术后的Hss评分比较,t=7.446,P<0.01,具有统计学意义,患者满意率为100%.结论髁限制性假体在膝关节通过软组织平衡技术无法获得相等的屈伸间隙或相等的内外侧紧张度时使用,在复杂初次膝关节置换及膝关节翻修手术中可以获得很好地临床效果.
목적분석과한제성가체재복잡초차슬관절치환이급슬관절번수수술중적응용경험,총결과한제성가체사용적괄응증급림상효과.방법2002년7월지2009년1월채용과한제성가체치료슬관절골성관절염15례(17슬),기중슬관절내번환자7례(8슬),슬관절외번환자5례(6례),슬관절번수3례.소유환자균사용가체연장병,병채용골수니고정연장간.수술전후대환슬진행Hss평분,대환자진행만의도조사.기록슬관절적굴신범위급병발증정황,슬관절X선정황래평고수술림상효과.결과평균수방24개월(14~72개월),출원시소유환자동통소실,관절은정,력선규정,말차수방시슬관절굴신활동범위유술전(58.9±18.8°),제고도술후(100.3±5.3°).Hss평분종술전(38.1±17)분,제고도술후적(80.78±7.6)분,술전、술후적Hss평분비교,t=7.446,P<0.01,구유통계학의의,환자만의솔위100%.결론과한제성가체재슬관절통과연조직평형기술무법획득상등적굴신간극혹상등적내외측긴장도시사용,재복잡초차슬관절치환급슬관절번수수술중가이획득흔호지림상효과.
Objective to analyze the experience of complex primary and revision knee replacement using condylar con-strained implants and a sum up of the indications and clinical results of this kind of prosthesis. Methods from July 2002 to January 2009,condylar constrained total knee arthroplasty was performed in 15 complex cases (17 knees),among them there were 5 cases(6 knees) with valgus knee,7 cases (8 knees) with severe varus knee,3 cases with revision knee. result all the patients were reviewed at mean 24 month follow up (range:14-72months). Preoperational knee paind is appeared completely at discharge with stablilizatively. the Hss score from preoperative (38.1 ± 17) points to the postoperation (80.78 ± 7.6) points, there were significant differences in preoperative and postoperative Hss score. the preoperative flexed motion range of articu-lation from preoperative(58.9±18.8°)points to the postoperation(100.3±5.3°).the dislocation and infection rate was zero and the patient satisfaction rate was 100%. conclusion Good curative effect can be get by use of constrained condylar implants form any complex primary and revision knee replacements with unobtainable flex-extension gap balance or equal tension of medial and lateral compartment through soft tissue balancing.