中华关节外科杂志（电子版）
中華關節外科雜誌（電子版）
중화관절외과잡지（전자판）
CHINESE JOURNAL OF JOINT SURGERY(ELECTRONIC VERSION)
2015年
3期
324-327
,共4页
翟文亮%王霏%陈闽贞%刘清秀
翟文亮%王霏%陳閩貞%劉清秀
적문량%왕비%진민정%류청수
关节成形术,置换,膝%膝关节%截骨术%放射学
關節成形術,置換,膝%膝關節%截骨術%放射學
관절성형술,치환,슬%슬관절%절골술%방사학
Arthroplasty,replacement,knee%Knee joint%Osteotomy%Radiology
目的：通过全膝关节置换术前、术后影像学测量及患者膝关节功能评估，初步总结中老年膝骨关节炎（ KOA）人群股骨前髁厚度（ ACO）的影像学参数，并探讨在全膝关节置换术中ACO对术后膝关节活动度的影响。方法自2010年1月至2012年12月因KOA行全膝关节置换术患者69例（82膝），男16例（20膝），女53例（62膝）；年龄45～78岁，平均63岁。测量患者术前及术后12周侧位X线片上股骨前髁的厚度、关节活动度及HSS评分，进行统计学分析。结果男性患者ACO平均值为（7.3±1.7）mm，女性为（7.3±1.4）mm，不同性别之间ACO差异无统计学意义（P＞0.01）；术前ACO为（7.3±1.5）mm，术后为（6.4±1.7）mm，差异有统计学意义（P＜0.01）；关节活动度及HSS评分术前与术后相比差异具有统计学意义（ P＜0.01）。结论中老年KOA人群ACO无性别差异；膝关节置换术后股骨前髁较术前变小，与股骨假体的设计及术中股骨截骨有关；膝关节股骨假体截骨时，可以适当前移截骨模块或增大股骨假体型号，在4 mm范围内不会引起髌股关节的填塞。
目的：通過全膝關節置換術前、術後影像學測量及患者膝關節功能評估，初步總結中老年膝骨關節炎（ KOA）人群股骨前髁厚度（ ACO）的影像學參數，併探討在全膝關節置換術中ACO對術後膝關節活動度的影響。方法自2010年1月至2012年12月因KOA行全膝關節置換術患者69例（82膝），男16例（20膝），女53例（62膝）；年齡45～78歲，平均63歲。測量患者術前及術後12週側位X線片上股骨前髁的厚度、關節活動度及HSS評分，進行統計學分析。結果男性患者ACO平均值為（7.3±1.7）mm，女性為（7.3±1.4）mm，不同性彆之間ACO差異無統計學意義（P＞0.01）；術前ACO為（7.3±1.5）mm，術後為（6.4±1.7）mm，差異有統計學意義（P＜0.01）；關節活動度及HSS評分術前與術後相比差異具有統計學意義（ P＜0.01）。結論中老年KOA人群ACO無性彆差異；膝關節置換術後股骨前髁較術前變小，與股骨假體的設計及術中股骨截骨有關；膝關節股骨假體截骨時，可以適噹前移截骨模塊或增大股骨假體型號，在4 mm範圍內不會引起髕股關節的填塞。
목적：통과전슬관절치환술전、술후영상학측량급환자슬관절공능평고，초보총결중노년슬골관절염（ KOA）인군고골전과후도（ ACO）적영상학삼수，병탐토재전슬관절치환술중ACO대술후슬관절활동도적영향。방법자2010년1월지2012년12월인KOA행전슬관절치환술환자69례（82슬），남16례（20슬），녀53례（62슬）；년령45～78세，평균63세。측량환자술전급술후12주측위X선편상고골전과적후도、관절활동도급HSS평분，진행통계학분석。결과남성환자ACO평균치위（7.3±1.7）mm，녀성위（7.3±1.4）mm，불동성별지간ACO차이무통계학의의（P＞0.01）；술전ACO위（7.3±1.5）mm，술후위（6.4±1.7）mm，차이유통계학의의（P＜0.01）；관절활동도급HSS평분술전여술후상비차이구유통계학의의（ P＜0.01）。결론중노년KOA인군ACO무성별차이；슬관절치환술후고골전과교술전변소，여고골가체적설계급술중고골절골유관；슬관절고골가체절골시，가이괄당전이절골모괴혹증대고골가체형호，재4 mm범위내불회인기빈고관절적전새。
Objective To preliminarily summary the image parameters of the femoral anterior condylar offset ( ACO) in the patients with knee osteoarthritis ( KOA) and investigate the influence of ACO on postoperative knee joint activity by radiographic measurement and functional assessment in total knee arthroplasty.Methods A total of 82 consecutive knees ( 69 patients ) were treated by total knee arthroplasty from Jan 2010 to Dec 2012, which included 16 males (20 knees) and 53 females (62 knees) with an average age of 63 years ( range, 45-78 years) .Outcomes were evaluated in the 3-month follow-up by ACO which was measured by the radiographs, hospital for special surgery ( HSS) knee score and the range of motion of the knee.Results The preoperative average femoral ACO in the male were ( 7.3 ± 1.7) mm, and (7.3 ±1.4) mm in the female;no significant difference between the male and the female was found ( P>0.01) .The postoperative average femoral ACO was thinner than the preoperative one and the difference was statistically significant (P<0.01).The differences in HSS sores and ROM between the preoperative results and the postoperative results were significant ( P <0.01 ) . Conclusions No gender difference exists in the femoral ACO of the elderly patients with knee osteoarthritis.Prosthesis design and intraoperative femoral condyle osteotomy may lead to a smaller postoperative ACO.If the changes are controlled within 4 mm, a little reduction of the osteotomy thickness in the anterior condyle or choosing a bigger prosthesis would not cause patellofemoral overstuff.
