中国医药导刊
中國醫藥導刊
중국의약도간
CHINESE JOURNAL OF MEDICAL GUIDE
2014年
12期
1441-1444
,共4页
股骨胫骨通配%胫骨平台骨缺损%重度内翻畸形%全膝关节置换术
股骨脛骨通配%脛骨平檯骨缺損%重度內翻畸形%全膝關節置換術
고골경골통배%경골평태골결손%중도내번기형%전슬관절치환술
Femur tibial prosthesis all-match%Tibial plateau bone defect%Severe varus deformity%Total knee arthroplasty
目的：探讨应用股骨-胫骨通配型全膝关节假体治疗合并胫骨平台骨缺损的重度内翻全膝的近期疗效。方法：对我院2012年1月至2013年5月40例（43膝）重度骨关节炎应用股骨-胫骨通配型全膝关节行全膝关节置换术，其中6例为合并内侧胫骨平台骨质缺损重度内翻畸形。术前检查膝关节活动度，用X线测量股胫角（femorotibial angle，FTA）测量KSS评分。手术采用髌旁内侧入路、常规截骨，胫骨平台骨质缺损病例采用适当增加胫骨平台截骨量、骨水泥填充及自体骨植骨并配合使用胫骨侧延长杆以增加膝关节假体的稳定性，所选假体为北京爱康宜诚公司生产的股骨-胫骨通配型全膝关节假体。术后测量FTA角，随访6个月至1年，定期测量膝关节活动度并采用KSS评分评定治疗效果。结果：患者手术均顺利完成。36例获得随访，其中包括合并胫骨平台骨质缺损5例。术后无切口感染、关节脱位等并发症。术后6个月按KSS评分法评定：优30例，良5例，中1例，优良率97℅，6例合并胫骨平台骨缺损病例均为优良。结论：应用股骨-胫骨通配型全膝关节假体治疗重度内翻膝疗效满意，尤其在治疗合并胫骨平台骨缺损病例时能有效解决股骨胫骨假体大小不匹配的问题，减少关节假体磨损率。
目的：探討應用股骨-脛骨通配型全膝關節假體治療閤併脛骨平檯骨缺損的重度內翻全膝的近期療效。方法：對我院2012年1月至2013年5月40例（43膝）重度骨關節炎應用股骨-脛骨通配型全膝關節行全膝關節置換術，其中6例為閤併內側脛骨平檯骨質缺損重度內翻畸形。術前檢查膝關節活動度，用X線測量股脛角（femorotibial angle，FTA）測量KSS評分。手術採用髕徬內側入路、常規截骨，脛骨平檯骨質缺損病例採用適噹增加脛骨平檯截骨量、骨水泥填充及自體骨植骨併配閤使用脛骨側延長桿以增加膝關節假體的穩定性，所選假體為北京愛康宜誠公司生產的股骨-脛骨通配型全膝關節假體。術後測量FTA角，隨訪6箇月至1年，定期測量膝關節活動度併採用KSS評分評定治療效果。結果：患者手術均順利完成。36例穫得隨訪，其中包括閤併脛骨平檯骨質缺損5例。術後無切口感染、關節脫位等併髮癥。術後6箇月按KSS評分法評定：優30例，良5例，中1例，優良率97℅，6例閤併脛骨平檯骨缺損病例均為優良。結論：應用股骨-脛骨通配型全膝關節假體治療重度內翻膝療效滿意，尤其在治療閤併脛骨平檯骨缺損病例時能有效解決股骨脛骨假體大小不匹配的問題，減少關節假體磨損率。
목적：탐토응용고골-경골통배형전슬관절가체치료합병경골평태골결손적중도내번전슬적근기료효。방법：대아원2012년1월지2013년5월40례（43슬）중도골관절염응용고골-경골통배형전슬관절행전슬관절치환술，기중6례위합병내측경골평태골질결손중도내번기형。술전검사슬관절활동도，용X선측량고경각（femorotibial angle，FTA）측량KSS평분。수술채용빈방내측입로、상규절골，경골평태골질결손병례채용괄당증가경골평태절골량、골수니전충급자체골식골병배합사용경골측연장간이증가슬관절가체적은정성，소선가체위북경애강의성공사생산적고골-경골통배형전슬관절가체。술후측량FTA각，수방6개월지1년，정기측량슬관절활동도병채용KSS평분평정치료효과。결과：환자수술균순리완성。36례획득수방，기중포괄합병경골평태골질결손5례。술후무절구감염、관절탈위등병발증。술후6개월안KSS평분법평정：우30례，량5례，중1례，우량솔97℅，6례합병경골평태골결손병례균위우량。결론：응용고골-경골통배형전슬관절가체치료중도내번슬료효만의，우기재치료합병경골평태골결손병례시능유효해결고골경골가체대소불필배적문제，감소관절가체마손솔。
[ABSTRACT]Objective: To study the femur tibial prosthesis all-match total knee prosthesis treatment with varus knee deformity combined with tibial plateau bone defect. Methods: From January 2012 and May 2012, 43 knees of 40 severe osteoarthritis patients underwent TKA with domestic AK femur tibial prosthesis all-match total knee prosthesis in our hospital that include 6 cases severe varus deformity combined with tibial plateau bone defect.For preoperative examination include measure the knee joint mobility and tibial femoral angle by using X ray (femorotibial angle, FTA), measuring KSS score.Took the medial parapatellar approach in surgery, conventional bone cutting, treatment for the tibial plateau bone defect cases with increasing cutting in tibia plateau, bone cement filling and autologous bone graft and tibia lateral extension rod in order to increase the stability of the knee joint prosthesis, the femur tibial prosthesis all-match total knee prosthesis took from Beijing AKEC Co., Ltd. For postoperative follow-up over 6 months to 1 year, regular measure the KSS score, knee joint mobility and the FTA, to evaluate the treatment effect. Results:The patients were successfully completed.36 cases received follow-up, included 6 cases of combined with the tibial plateau bone defect.No complications such as postoperative incision infection and joint dislocation.According to the KSS score method to evaluate after 6 months: 30 cases excellent, 5 cases good, and 1 case medium, good rate was 97℅, 5 cases severe varus deformity combined with tibial plateau bone defect was good. Conclusion: Use the femur tibial prosthesis all-match total knee prosthesis to treatment for severe varus deformity, especially for the combined with tibial plateau bone defect cases, it could solve the problems of the femurs tibial prosthesis size does not match in TKA, and reduce prosthesis wear rate.
