中国组织工程研究 ›› 2022, Vol. 26 ›› Issue (6): 892-897.doi: 10.12307/2022.172

• 人工假体Artificial prosthesis • 上一篇    下一篇

后交叉韧带保留型假体全膝关节置换治疗膝骨性关节炎合并膝外翻畸形

周建国1,刘世伟1,袁长红2,毕声荣1,杨国平1,胡伟全1,刘  辉1,钱  锐1   

  1. 1南昌大学附属赣州医院关节外科,江西省赣州市   341000;2江西省赣州市信丰县疾病预防控制中心,江西省赣州市   341600
  • 收稿日期:2021-03-27 修回日期:2021-04-01 接受日期:2021-05-26 出版日期:2022-02-28 发布日期:2021-12-07
  • 通讯作者: 钱锐,主任医师,南昌大学附属赣州医院关节外科,江西省赣州市 341000
  • 作者简介:周建国,男,1984年生,汉族,副主任医师,在读博士,主要从事微创人工关节置换、创伤骨科、微创关节镜外科、显微修复重建外科临床与基础研究。 刘世伟,男,1992年生,汉族,医师,主要从事微创人工关节置换、微创关节镜外科、骨缺损修复临床与基础研究。
  • 基金资助:
    江西省卫健委科技计划项目(20177236),项目负责人:周建国;江西省卫健委科技计划项目(20195067),项目参与者:周建国;赣州市科技计划项目(GZ2020ZSF165),项目负责人:周建国;赣州市卫健委科技计划项目(2020-1-3),项目负责人:周建国

Total knee arthroplasty with posterior cruciate ligament retaining prosthesis in the treatment of knee osteoarthritis with knee valgus deformity

Zhou Jianguo1, Liu Shiwei1, Yuan Changhong2, Bi Shengrong1, Yang Guoping1, Hu Weiquan1, Liu Hui1, Qian Rui1   

  1. 1Department of Joint Surgery, Affiliated Ganzhou Hospital of Nanchang University, Ganzhou 341000, Jiangxi Province, China; 2Center for Disease Control and Prevention of Xinfeng County, Ganzhou 341600, Jiangxi Province, China
  • Received:2021-03-27 Revised:2021-04-01 Accepted:2021-05-26 Online:2022-02-28 Published:2021-12-07
  • Contact: Qian Rui, Chief physician, Department of Joint Surgery, Affiliated Ganzhou Hospital of Nanchang University, Ganzhou 341000, Jiangxi Province, China
  • About author:Zhou Jianguo, Associate chief physician, Doctoral candidate, Department of Joint Surgery, Affiliated Ganzhou Hospital of Nanchang University, Ganzhou 341000, Jiangxi Province, China Liu Shiwei, Physician, Department of Joint Surgery, Affiliated Ganzhou Hospital of Nanchang University, Ganzhou 341000, Jiangxi Province, China Zhou Jianguo and Liu Shiwei contributed equally to this article.
  • Supported by:
    the Science and Technology Plan Project of Jiangxi Provincial Health Commission, No. 20177236 (to ZJG), No. 20195067 (to ZJG); the Science and Technology Plan Project of Ganzhou, No. GZ2020ZSF165 (to ZJG); the Science and Technology Plan Project of Ganzhou Municipal Health Commission, No. 2020-1-3 (to ZJG)

摘要:

文题释义:
全膝关节置换:是利用人工膝关节假体置换系统治疗膝骨性关节炎、类风湿性关节炎等膝关节终末期疾病的一种主要手术方式,能有效矫正畸形、解除症状、恢复膝关节功能,提高患者生活质量。
后交叉韧带保留型假体:膝关节置换假体根据是否保留后交叉韧带分为后交叉韧带保留型假体及后方稳定型假体,后交叉韧带保留型假体能够保留更多本体感觉,降低髌股关节应力,通过股骨后轮滚动增强股四头肌功能,使潜在的膝关节活动范围增加,术后步态更趋于正常,提高患者满意度。

背景:有研究表明,人工全膝关节置换中使用后交叉韧带保留型假体可保留更多本体感觉,降低髌股关节应力,通过股骨后轮滚动增强股四头肌功能,增加膝关节活动范围增加,使患者术后步态更趋于正常,提高患者满意度。
目的:探讨采用后交叉韧带保留型假体的人工全膝关节置换治疗膝关节骨性关节炎合并膝外翻畸形的临床疗效。
方法:收集南昌大学附属赣州医院关节外科2018年11月至2020年12月收治,采用后交叉韧带保留型假体进行初次人工全膝关节置换的膝关节骨性关节炎合并膝外翻畸形患者30例(均为单膝置换),进行回顾性分析。术前及术后2周、3个月检测30例患者的膝外翻角与膝关节活动度,采用HSS评分评价膝关节功能。研究已通过南昌大学附属赣州医院伦理委员会批准(批准号TY-ZKY2021-009-01)。
结果与结论:①30例患者术后2周、3个月的膝外翻角检测结果均小于术前(P < 0.05),术后3周与术后3个月检测结果比较差异无显著性意义(P > 0.05)。②30例患者术后2周、3个月的膝关节活动度检测结果均高于术前(P < 0.05),术后3周与术后3个月检测结果比较差异无显著性意义(P > 0.05)。③30例患者术后2周、3个月的总体HSS评分均高于术前(P < 0.05),术后3周与术后3个月检测结果比较差异无显著性意义(P > 0.05)。④结果表明,采用后交叉韧带保留型假体的人工全膝关节置换治疗膝关节骨性关节炎合并膝外翻畸形能够有效纠正膝关节畸形、减轻膝关节疼痛、提高患肢肌力、显著改善膝关节活动度及功能,临床疗效显著。

https://orcid.org/0000-0001-6651-2701 (周建国) 

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程

关键词: 后交叉韧带, 膝关节假体, 全膝关节置换, 骨性关节炎, 膝外翻, 膝关节疼痛, 膝关节活动度, 临床疗效

Abstract: BACKGROUND: Studies have shown that the use of posterior cruciate ligament retaining prosthesis in total knee arthroplasty can retain more proprioception, reduce the stress of patellofemoral joint, enhance the function of quadriceps femoris through the rolling of femoral rear wheel, increase the range of motion of knee joint, make the gait of patients more normal, and improve the satisfaction of patients.  
OBJECTIVE: To explore the clinical efficacy of total knee arthroplasty with posterior cruciate ligament retaining prosthesis in the treatment of knee osteoarthritis with knee valgus deformity.
METHODS:  From November 2018 to December 2020, data of 30 patients (all single knee arthroplasty) with knee osteoarthritis and genu valgus deformity who underwent primary total knee arthroplasty with posterior cruciate ligament retaining prosthesis in the Department of Joint Surgery of the Affiliated Ganzhou Hospital of Nanchang University were retrospectively analyzed. The knee valgus angle and range of motion of 30 patients were measured before operation and 2 weeks and 3 months after operation, and the knee function was evaluated by HSS. The study has been approved by the Ethics Committee of the Affiliated Ganzhou Hospital of Nanchang University (approval No. TY-ZKY2021-009-01).  
RESULTS AND CONCLUSION: (1) The knee valgus angle of 30 patients at 2 weeks and 3 months after operation was less than that before operation (P < 0.05), and there was no significant difference in knee valgus angle between 3 weeks and 3 months after operation (P > 0.05). (2) The range of motion of knee joint in 30 patients at 2 weeks and 3 months after operation was higher than that before operation (P < 0.05). There was no significant difference in range of motion of knee joint between 3 weeks and 3 months after operation (P > 0.05). (3) The overall HSS scores of 30 patients at 2 weeks and 3 months after operation were higher than those before operation (P < 0.05), and there was no significant difference in overall HSS scores between 3 weeks and 3 months after operation (P > 0.05). (4) The results showed that total knee arthroplasty with posterior cruciate ligament retaining prosthesis can effectively correct the deformity of knee joint, reduce the pain of knee joint, improve the muscle strength of affected limb, and significantly improve the range of motion and function of knee joint, showing significant clinical effect.

Key words: posterior cruciate ligament, artificial knee prosthesis, total knee arthroplasty, osteoarthritis, knee valgus, knee joint pain, range of motion of knee joint, clinical effect

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