中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (48): 8953-8957.doi: 10.3969/j.issn.2095-4344.2012.48.005

• 人工假体 artificial prosthesis • 上一篇    下一篇

活动与固定衬垫全膝关节置换后膝关节的活动

罗 炜，成明华，肖勋刚   

  1. 郴州市第一人民医院骨科，湖南省郴州市 423000
  • 收稿日期:2012-05-18 修回日期:2012-07-24 出版日期:2012-11-25 发布日期:2012-11-25
  • 作者简介:罗炜，男，1975年生，湖南省郴州市人，汉族，1998年南华大学毕业，副主任医师，主要从事骨关节外科方面的研究。 luowei0735@163.com

Knee joint movement after fixed-bearing and mobile-bearing total knee arthroplasty

Luo Wei, Cheng Ming-hua, Xiao Xun-gang   

  1. Department of Orthopedics, the First People’s Hospital of Chengzhou, chengzhou 423000, Hunan Province, China
  • Received:2012-05-18 Revised:2012-07-24 Online:2012-11-25 Published:2012-11-25
  • About author:Luo Wei, Associate chief physician, Department of Orthopedics, the First People’s Hospital of Chengzhou, chengzhou 423000, Hunan Province, China luowei0735@163.com

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649

被引次数

4

摘要：

背景：目前，在全膝关节置换时无论是使用活动衬垫还是固定衬垫，全膝关节置换后中长期的功能转归和再手术率都相同，但是近期患膝关节功能改善情况各专家意见并不一致。
目的：分析活动衬垫型与固定衬垫型假体全膝关节置换后膝关节相关活动的角度变化，以探讨置换后关节活动的改善情况。
方法：选择2005年1月至2012年12月确诊为膝关节骨关节炎且患膝既往无手术史的患者90例，应用固定衬垫型假体或活动衬垫型假体进行全膝关节置换治疗。测量患者置换前膝关节活动度，置换后股骨角、胫骨角、膝外翻角、胫骨平台后倾角、髌骨高度。
结果与结论：置换后随访4-36个月，末次随访时活动衬垫组的最大屈曲度大于固定衬垫组，差异有显著性意义(P < 0.05)。末次随访时两组的股骨角、胫骨角、膝外翻角、胫骨平台后倾角比较，差异无显著性意义(P > 0.05)。置换前后髌骨高度比较，差异无显著性意义(P > 0.05)。说明活动衬垫型和固定衬垫型假体全膝关节置换后近期患膝关节功能明显改善，且活动衬垫型效果更令人满意。

关键词: 膝关节, 关节置换, 膝关节成形术, 固定衬垫, 活动衬垫, 膝关节最大屈曲度, 胫骨平台后倾角

Abstract:

BACKGROUND: To date, the medium-and long-term functional outcome after total knee replacement and the reoperation rate of using the fixed-bearing total knee arthroplasty is same with that of using mobile-bearing total knee arthroplasty, but there are different opinions for the knee function improvement.
OBJECTIVE: To compare the knee joint movement angle after fixed-bearing or mobile-bearing total knee arthroplasty in order to investigate the improvement of joint motion.
METHODS: From January 2005 to December 2012, 90 osteoarthritis patients without operation history were treated by fixed-bearing total knee arthroplasty (n=47) or mobile-bearing total knee arthroplasty (n=43). Both the range of motion of the knee joint before replacement and the femoral angle, the tibia angle, knee valgus angle, tibial plateau posterior slope and patellar height after replacement were measured.
RESULTS AND CONCLUSION: All the patients were followed-up for 4-36 months, and in the final follow-up, the maximum flexion after replacement in the mobile-bearing group was larger than that in the fixed-bearing group, and the difference was not significant (P < 0.05). There was no significant difference of the femoral angle, the tibia angle, knee valgus angle and tibial plateau posterior slope between two groups in the final follow-up (P > 0.05), and there was no significant difference of patellar height between two groups in the final follow-up (P > 0.05). It indicated that both mobile-bearing and fixed-bearing total knee arthroplasty could improve the knee function, and recently study found that the clinical outcomes of mobile-bearing were better than that of fixed-bearing.

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