中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (26): 4852-4855.doi: 10.3969/j.issn.1673-8225.2010.26.025

• 骨科植入物 orthopedic implant • 上一篇    下一篇

“女性膝”置换前后膝关节伸屈活动11例评价

王西彬，孙永强   

  1. 河南中医学院第二附属医院，河南省郑州市450002
  • 出版日期:2010-06-25 发布日期:2010-06-25
  • 作者简介:王西彬，男，1976年生，河南省郸城县人，汉族，河南中医学院毕业，硕士，主治医师，主要从事退行性骨性关节病方面的研究。 wangxibin1976@163.com

Evaluation of flexion-extension motion of knee joints prior to and after “female knee” replacement in 11 cases

Wang Xi-bin, Sun Yong-qiang   

  1. Second Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou  450002, Henan Province, China
  • Online:2010-06-25 Published:2010-06-25
  • About author:Wang Xi-bin, Master, Attending physician, Second Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450002, Henan Province, China wangxibin1976@163.com

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摘要：

背景：当前所用的膝关节表面置换假体大多为男性设计，与女性自身的生理解剖特点有很大的差异。而临床解剖研究发现，男女膝关节外形，尤其是髌股关节存在着明显的差异性，这样以来，女性患者膝关节表面置换以后与男性相比出现了较多的并发症。
目的：观察“女性膝”在膝关节置换后的膝关节功能及伸屈活动度，并分析其在髌股关节方面的设计特点。
方法：应用捷迈公司的健达“女性膝”治疗老年女性膝关节骨关节炎患者11例13膝，年龄61~81岁，双膝关节2例，13膝均有不同程度的屈曲和内翻畸形，比较分析“女性膝”置换前后的患者膝关节功能及伸屈活动度。按照美国特种外科医院(HSS)评分对患者膝关节功能进行评价，HSS评分满分100分，85分以上为优，70~84分为良，60~69分尚可，60分以下为差。
结果与结论：所有膝置换后12周膝关节HSS评分均显著高于置换前(P < 0.01)；膝关节屈伸活动范围明显大于置换前(P < 0.01)。膝关节肌力及稳定性均有所增加，能满足患者日常生活需要，生活质量明显提高。提示“女性膝”的设计与亚洲女性膝关节解剖特点更加匹配，临床应用能够取得更好的效果。

关键词: 女性膝, 关节置换, 骨关节炎, 髌股关节, 生物力学

Abstract:

BACKGROUND: Most of knee replacement prosthesis is designed for male, which differs from female in physiological and anatomical characteristics. Clinical anatomy showed that, the shape of knee joints has great differences between males and females, especially in patellofemoral joint. Accordingly, compared with males, the complications in females following knee replacement are greater.
OBJECTIVE: To observe the function and range of motion of knee joint after “female knee” replacement, and to analyze the design features of “female knee” in dealing with patellofemoral joint.
METHODS: Totally 11 (13 knees) female cases who suffered from knee osteoarthritis and were treated by “female knee” replacement (Jianda, Zimmer Cooperation, USA) were selected. The ages of cases were 61-81 yearsold, and 2 cases suffered form both knee osteoarthritis. All knees had flexion or inversion deformity. The function and range of motion of knee joints were compared before and after “female knee” replacement. The hospital for special surgery (HSS) knee rating scale was used to evaluate knee functions. The full score of HSS was 100, over 85 were excellent, 70-84 were good, 60-69 were fair and lower than 60 were poor. 
RESULTS AND CONCLUSION: Compared with before replacement, the HSS scores of knee joints were increased (P < 0.01), and the range of motion was greater in all cases at 12 weeks after replacement (P < 0.01). The strength and stability of knee were increased, which could meet the needs of daily life and increase living standard of patients. Results demonstrated that the design of “female knee” is identical to anatomical characteristics of Arian females, which can achieve good therapeutic effects in clinical application.

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