中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (4): 476-480.doi: 10.3969/j.issn.2095-4344.2016.04.004

• 人工假体 artificial prosthesis • 上一篇    下一篇

老年全膝关节置换中髌骨侧方移位后的功能康复及并发症分析

孙 锋1，王俊新1，王黎明2，王 彤2   

  1. 1张家港市第六人民医院骨科，江苏省张家港市 215600；2南京市第一医院骨科，江苏省南京市 210000
  • 收稿日期:2015-11-07 出版日期:2016-01-22 发布日期:2016-01-22
  • 通讯作者: 孙锋，张家港市第六人民医院骨科，江苏省张家港市 215600
  • 作者简介:孙锋，男，1963年生，汉族，教授，主任医师，主要从事骨科相关疾病的诊治和研究。
  • 基金资助:

    国家自然科学基金(81171851)

Functional recovery and complications in elderly patients with total knee arthroplasty after patellar lateral displacement

Sun Feng1, Wang Jun-xin1, Wang Li-ming2, Wang Tong2   

  1. 1Department of Orthopedics, Sixth People’s Hospital, Zhangjiagang 215600, Jiangsu Province, China; 2Department of Orthopedics, First Hospital of Nanjing City, Nanjing 210000, Jiangsu Province, China
  • Received:2015-11-07 Online:2016-01-22 Published:2016-01-22
  • Contact: Sun Feng, Department of Orthopedics, Sixth People’s Hospital, Zhangjiagang 215600, Jiangsu Province, China
  • About author:Sun Feng, Professor, Chief physician, Department of Orthopedics, Sixth People’s Hospital, Zhangjiagang 215600, Jiangsu Province, China
  • Supported by:

     the National Natural Science Foundation of China, No. 81171851

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被引次数

4

摘要：

文章快速阅读：

文题释义：

髌骨侧方移位：是一种在膝关节置换中代替髌骨翻转的微创疗法，手术中对髌骨实施侧方移位，可减少出血时间和出血量，术后并发症少，有利于改善膝关节功能。
髌骨翻转：在人工全膝关节置换中为满足关节间隙清晰所采取的一种移位方式，可保证假体的正确置放，但常造成患者置换后发生疼痛。髌骨翻转对患者置换后恢复易造成不利影响，会延长患者实现直腿抬高时间及膝关节活动时间，一些研究认为全膝关节置换中髌骨翻转不利于置换后功能的恢复。

 

背景：人工全膝关节置换治疗膝关节骨关节炎可有效根除晚期膝关节病痛的程度，矫正畸形，改善关节功能，但该方法使用髌骨翻转不利于患者置换后恢复，且易造成置换后并发症。因此，以髌骨侧方移位代替髌骨翻转的微创疗法逐渐受到人们的关注，其手术优良率也随之提高。
目的：观察老年全膝关节置换中髌骨翻转与髌骨侧方移位对置换后膝关节功能康复及并发症的影响。
方法：选择老年双侧膝关节骨关节炎患者40例共80膝，所有患者随机分为2组，每组各20例，共40膝。研究组患者全膝关节置换时使用髌骨侧方移位术，对照组患者使用髌骨翻转术。置换后1周，3个月，6个月，1年比较两组患者疗效、膝关节功能恢复情况及并发症发生情况。
结果与结论：两组患者置换后膝关节90°屈曲时间比较差异无显著性意义(P > 0.05)；研究组患者置换后实现主动直腿抬高时间短于对照组(P < 0.05)。研究组患者除置换后6个月膝关节被动活动度与对照组比较差异无显著性意义，其他各时间点膝关节主动和被动活动度均显著优于对照组(P < 0.05)；两组患者置换后疼痛目测类比评分评分和术后并发症发生情况比较差异无显著性意义(P > 0.05)。结果证实，老年全膝关节置换中使用髌骨侧方移位利于患者置换后早期膝关节功能恢复，安全可靠。 

ORCID: 0000-0003-0097-7199(孙锋)

关键词: 骨科植入物, 人工假体, 髌骨翻转, 老年, 全膝关节置换, 髌骨侧方移位, 疗效, 膝关节主动活动度, 膝关节被动活动度, 疼痛目测类比评分, 并发症, 膝关节功能, 国家自然科学基金

Abstract:

BACKGROUND: Artificial total knee arthroplasty in the treatment of knee osteoarthritis can effectively eradicate the late knee pain, correct deformity, improve joint function, but the use of patella is not conducive to the recovery, and it is easy to cause postoperative complications. Therefore, patellar lateral shift, instead of patella minimally invasive therapy, has attracted more and more people’s attention, which increased excellent and good rate of operation.
OBJECTIVE: To investigate the effects of patellar turnover and patellar lateral displacement on knee function 
recovery and complications of elderly patients with total knee arthroplasty.
METHODS: A total of 80 knees of 40 elderly patients with bilateral knee osteoarthritis were selected. All patients according to the random number table method were divided into two groups with 40 knees of 20 cases in each group. The patients in the study group received patellar lateral shift operation, while the patients in the control group received the patellar turnover. Curative effects, the recovery of knee joint function and occurrence of complications were compared between the two groups at 1 week, 3 months, 6 months and 1 year after arthroplasty. 
RESULTS AND CONCLUSION: No significant difference in 90° flexion time in the knee was detected between the two groups after replacement (P > 0.05). Active straight leg raising time was shorter in the study group than in the control group (P < 0.05). No significant difference in passive range of motion was detectable between the two groups at 6 months after replacement. Active and passive ranges of motion were significantly better in the study group than in the control group at various time points (P < 0.05). There were no significant differences in Visual Analog Scale pain scores and postoperative complications between the two groups (P > 0.05). These results verified that patellar lateral displacement for elderly patients with total knee arthroplasty is conducive to early knee function recovery after surgery, and it is safe and reliable.