CAJ | 학술논문

背景:人工全膝关节置换后膝前痛的主要原因是髌股关节并发症. 目的:探讨全膝关节置换过程中髌股关节轨迹不良的处理方法. 方法:31例32膝在全膝关节置换过程中出现髌股关节轨迹不良,均为女性,年龄53-85岁,平均68.5岁,病程8-25年,平均22.3年,其中骨性关节炎27例28膝,类风湿性关节炎4例4膝.膝外翻角12°-32°,平均20°;Q 角为13°-23°,平均16°.采用正确截骨,调整假体位置,髌骨内外侧软组织平衡,或加行 Goldthwait-Roux 术进行纠正. 结果与结论:随访时间12-120个月.膝关节平均活动度数(98.2±10.3)°.KSS 评分从置换前平均35分提高到置换后平均81分;KSS 功能评分从置换前平均34分提高到置换后平均83分.置换后切口均Ⅰ期愈合,未发生皮肤坏死、切口感染等并发症.屈膝45° Knutsson 髌骨轴位 X 射线片检查无髌骨倾斜、半脱位或脱位.结果说明在全膝关节置换过程中出现髌股关节轨迹不良时采用稳定性假体,正确截骨及调整假体位置,髌骨内外侧软组织平衡,或加行 Goldthwait-Roux 术,可取得比较满意的疗效.
배경:인공전슬관절치환후슬전통적주요원인시빈고관절병발증. 목적:탐토전슬관절치환과정중빈고관절궤적불량적처리방법. 방법:31례32슬재전슬관절치환과정중출현빈고관절궤적불량,균위녀성,년령53-85세,평균68.5세,병정8-25년,평균22.3년,기중골성관절염27례28슬,류풍습성관절염4례4슬.슬외번각12°-32°,평균20°;Q 각위13°-23°,평균16°.채용정학절골,조정가체위치,빈골내외측연조직평형,혹가행 Goldthwait-Roux 술진행규정. 결과여결론:수방시간12-120개월.슬관절평균활동도수(98.2±10.3)°.KSS 평분종치환전평균35분제고도치환후평균81분;KSS 공능평분종치환전평균34분제고도치환후평균83분.치환후절구균Ⅰ기유합,미발생피부배사、절구감염등병발증.굴슬45° Knutsson 빈골축위 X 사선편검사무빈골경사、반탈위혹탈위.결과설명재전슬관절치환과정중출현빈고관절궤적불량시채용은정성가체,정학절골급조정가체위치,빈골내외측연조직평형,혹가행 Goldthwait-Roux 술,가취득비교만의적료효.
@@@@BACKGROUND: The complication of patel ofemoral joint is the main cause of anterior knee pain after total knee arthroplasty. @@@@OBJECTIVE: To explore the strategies and treatment methods of patel ofemoral maltracking in total knee arthroplasty. @@@@METHODS: Thirty-one patients (32 knee joints) had patel ofemoral maltracking in total knee arthroplast. Al the patients were female, aged 53-85 years old, averaged in 68.5 years old. The course of the disease was 8-25 years (22.3 years on average). Among al the cases, 28 knees of 27 cases were diagnosed as having osteoarthritis, four knees of four cases were rheumatoid arthritis. The valgus angle was 12°-32° (20°on average) and the Q angle was 13°-23° (16° on average). Correct osteotomy and prosthesis position adjustment, balancing soft tissue of lateral and medial side of the patel a or Goldthwait-Roux methods were used for correcting patel ofemoral maltracking in total knee arthroplasty. @@@@RESULTS AND CONCLUSION: Al the patients were fol owed-up for 12-120 months postoperatively. Average range of motion of the knee joint was (98.2±10.3)°. The Knee Society Score was increased from preoperative 35 points to postoperative 81 points; and the function score of Knee Society Score was increased from preoperative 34 points to postoperative 83 points. After replacement, al incisions were wel -healed by first intension, and complications such as necrosis of the skin and wound infection did not occur. Knutsson X-ray on axial position of the patel a for 45° inflexion of the knee was found no tilt, subluxation or dislocation of the patel a. For correcting patel ofemoral maltracking in total knee arthroplasty, adopting stabilized prosthesis, using osteotomy and adjusting the prosthesis position correctly, balancing soft tissue of lateral and medial side of the patel a or Goldthwait-Roux can achieve quite satisfactory results.