發(fā)布時間：2018-05-16 18:53

  本文選題：膝關節(jié)翻修術 + 關節(jié)線�。� 參考：《山東醫(yī)藥》2017年16期

【摘要】：目的探討膝關節(jié)翻修術后關節(jié)線變化對膝關節(jié)功能的影響。方法選擇擬行膝關節(jié)翻修術患者89例(共89膝),均植入LCCK髁限制性膝關節(jié)假體進行膝關節(jié)翻修術。術前及術后24個月,根據(jù)X線平片檢查結果測量關節(jié)線,比較關節(jié)線變化≤2 mm、2~≤4 mm、4 mm者手術前后膝關節(jié)評分、功能評分、Feller髕骨評分及膝關節(jié)活動度。比較術中應用或未應用脛骨、股骨金屬填充塊者的關節(jié)線變化及上述膝關節(jié)功能相關指標。結果患者術后關節(jié)線變化為-4.1~8.9 mm,上移70例、下移19例;關節(jié)線變化≤2 mm 23例,2~≤4 mm 35例,4 mm 31例。與術前比較,相同關節(jié)線變化者術后膝關節(jié)評分、功能評分、Feller髕骨評分及膝關節(jié)活動度均升高(P均0.01);但關節(jié)線變化≤2 mm及2~≤4 mm者術后膝關節(jié)評分、功能評分、Feller髕骨評分均高于關節(jié)線變化4mm者(P均0.01)。術中應用股骨金屬填充塊40例、未應用49例,其術后關節(jié)線變化分別為-4.1~7.9(1.9±3.4)、2.2~8.9(3.5±3.4)mm,二者比較P0.05。術中應用脛骨金屬填充塊14例、未應用75例,二者術后關節(jié)線變化比較P0.05。應用股骨金屬填充塊者術后功能評分、Feller髕骨評分均高于未應用者(P0.05或0.01),應用與未應用脛骨金屬填充塊者術后膝關節(jié)評分、功能評分、Feller髕骨評分、膝關節(jié)活動度比較差異均無統(tǒng)計學意義(P均0.05)。結論膝關節(jié)翻修術后關節(jié)線變化4 mm的患者膝關節(jié)功能較差,術中應用股骨金屬填充塊有利于減小關節(jié)線變化及提高膝關節(jié)功能,而脛骨金屬填充塊則無明顯作用。
[Abstract]:Objective to investigate the effect of the change of the joint line on the function of the knee joint after the knee arthroplasty. Methods 89 patients (89 knees) were selected for the knee arthroplasty (total 89 knees), and the LCCK condyle prosthesis was implanted into the knee arthroplasty. The joint lines were measured before and 24 months after the operation, and the changes of the joint line were less than 2 mm, 2~ 4 mm, 4 mm before and after operation knee joint score, function score, Feller patellar score and knee joint activity. Compare the changes of the joint line of the tibia and the femoral metal filling block in the operation and the related indexes of the above knee joint function. Results the joint line changes after the operation were -4.1~8.9 mm, 70 cases were moved up, 19 cases were moved down and the joint line changes were changed. < 2 mm > 23 cases, 2~ < 4 mm 35 cases, 4 mm 31 cases. Compared with pre operation, the knee joint score, function score, Feller patellar score and knee joint activity increased (P 0.01), but the knee joint line changes less than 2 mm and 2~ < 4 mm, the function score, and the Feller patellar score were higher than those of the 4mm on the joint line. P 0.01). 40 cases of femoral metal filling block were used during the operation, and 49 cases were not used. The postoperative joint line changes were -4.1~7.9 (1.9 + 3.4) and 2.2~8.9 (3.5 + 3.4) mm respectively. Two were compared with 14 cases of tibial metal filling block in P0.05. operation, 75 cases were not used. The postoperative functional score of femoral metal filling block in P0.05. application was compared with P0.05. after operation, Fel The ler patellar scores were all higher than those of those who were not used (P0.05 or 0.01). There was no significant difference in knee joint score, functional score, Feller patellar score and knee joint activity (P 0.05). Conclusion the knee joint function of patients with 4 mm after knee arthroplasty was poor, and the operation was applied during the operation. The metal filling block of femur is beneficial to reduce the change of the joint line and improve the function of the knee joint, while the tibial metal filling block has no obvious effect.

【作者單位】： 北京積水潭醫(yī)院;
【基金】：國家自然科學基金資助項目(81472139)
【分類號】：R687.4

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本文編號：1898019