后路稳定型与后路交叉关节保留型全膝关节置换术中期疗效比较

中国医师进修杂志 Pub Date : 2012-02-15 DOI:10.3760/CMA.J.ISSN.1673-4904.2012.05.003

Hong-ming Zheng, Jun-Ying Sun, Sheng-jie Dong, Ye Jin, Qiang Wang

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引用次数: 0

摘要

目的评价后路稳定型(PS)全膝关节置换术(TKA)和后路交叉保留型(CR)全膝关节置换术的中期疗效，探讨临床相关问题。方法回顾性分析1992年5月~ 2006年5月84例(87膝)原发性全膝关节置换术的临床资料。比较PS TKA (PS组41例，43膝)与CR TKA (CR组43例，44膝)的中期疗效。结果随访5 ~ 10年(7.6±1.5)年，两组患者均未发生感染、脱位及神经血管损伤。PS组术中发生股骨后外侧髁骨折1例。PS组和CR组的外侧支持带释放率分别为2.3%(1/43)和2.3%(1/44)。PS组和CR组术后6个月膝关节前侧疼痛发生率分别为4.7%(2/43)和4.5%(2/44)。随访结束时，两组患者膝关节前侧疼痛发生率均为0。两组患者侧支持带释放率及膝关节前疼痛发生率比较，差异均无统计学意义(P < 0.05)。两组患者的活动范围和美国膝关节社会评分(KSS)相似，差异无统计学意义(P < 0.05)。随访结束时，PS组和CR组髌骨倾斜或半脱位的x线发生率分别为2.3%(1/43)和2.3%(1/44)。两组间比较差异无统计学意义(P < 0.05)。随访结束时，两组患者均未见骨溶解、x线透光带及假体松动。没有因松动或其他原因而修订。结论PS TKA与CR TKA的中期疗效相近。但未来疗效仍需进一步随访。关键词:关节置换术，置换，膝关节;治疗结果

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Comparison of intermediate term efficacy between posterior stabilized and posterior cruciateretaining total knee arthroplasty

Objective To evaluate the intermediate term efficacy of posterior stabilized (PS) total knee arthroplasty(TKA) and posterior cruciate-retaining(CR) TKA and explore the clinical related problem.Methods The clinical data of 84 patients (87 knees) who treated with primary TKA from May 1992 to May 2006 were analyzed retrospectively.The intermediate term efficacy was compared between PS TKA (PS group,41 cases with 43 knees) and CR TKA (CR group,43 cases with 44 knees).Results All the patients were followed up for 5-10(7.6 ± 1.5 ) years,no infection,dislocation or neurovascular injury occurred in both groups.But 1 knee occurred intraoperative posterolateral femoral condyle fracture in PS group.The lateral retinacular release rate was 2.3％ ( 1/43 ) and 2.3％ (1/44) in PS group and CR group,respectively.The incidence of anterior knee pain was 4.7％(2/43 ) and 4.5％(2/44) after 6 months surgery in PS group and CR group.The incidence of anterior knee pain was 0 at the end of follow-up in both groups.There was no significant difference in the lateral retinacular release rate and the incidence of anterior knee pain between two groups (P ＞0.05).The range of motion and American knee society score (KSS) was similar and no statistical difference was found between two groups(P ＞ 0.05 ).The incidence of patellar tilt or subluxation in X-ray was 2.3％ (1/43) and 2.3％ (1/44) at the end of follow-up in PS group and CR group.There was no significant difference between two groups (P ＞ 0.05 ).At the end of follow-up,no osteolysis,X-ray radiolucent zone and prosthesis loosening were found in both groups.There was no revision owing to loosening or other reasons.Conclusions The intermediate term efficacy of PS TKA and CR TKA is near a tie.However,the future efficacy still need further follow-up. Key words: Arthroplasty,replacement,knee; Treatment outcome

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中国医师进修杂志

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期刊介绍： Chinese Journal of Postgraduates of Medicine (founded in 1978, monthly) is one of the series of journals of the Chinese Medical Association (CMA) under the supervision of the National Health Commission of the People's Republic of China, sponsored by the Chinese Medical Association (CMA) and Dalian Institute of Theoretical Medicine (DITM). It is a core journal of Chinese science and technology, a statistical source journal of Chinese scientific and technical papers, and a statistical source journal of China Academic Journal Impact Factor Annual Report. The journal adheres to the purpose of using continuing medical education and post training, highlights new theories, new knowledge, new methods and new technologies, and focuses on the combination of theory and practice, and the combination of popularisation and improvement. Main columns: Special tutorials, expert forums, clinical treatises, clinical experience, reviews and lectures, continuing medical education, teaching and research, advanced training forum, drugs and clinics, overview of progress, introduction of new technologies, imaging and clinics, lessons learnt, discussions and evaluations, case reports, discussions of clinical cases, conference proceedings, and domestic and international academic developments. The main target readers are clinical medical personnel in internal medicine, surgery, gynaecology, paediatrics and ophthalmology.