实用医学杂志 ›› 2022, Vol. 38 ›› Issue (4): 415-420.doi: 10.3969/j.issn.1006⁃5725.2022.04.005

• 专题报道 • 上一篇    下一篇

两种不同截骨方式对全膝关节术后患者下肢力线和软骨退变的影响

吴迪1 司丽娜2 武丽珠3 王建华1 罗金伟1 常乾坤1 吕永明1 杨阳1   

  1. 1承德医学院附属医院(河北承德 067000);2承德医学院(河北承德 067000);3承德市中心医院(河北承德 067000)

  • 出版日期:2022-02-25 发布日期:2022-02-25
  • 通讯作者: 杨阳 E⁃mail:yydpj1976@163.com
  • 基金资助:
    承德市科学技术研究与发展计划项目(编号:202109A034)

Effects of two different osteotomy methods on lower limb alignment and cartilage degeneration in patientsafter total knee joint surgery

WU Di*,SI Li′na,WU Lizhu,WANG Jianhua,LUO Jinwei,CHANG Qiankun,LÜ Yongming,YANG Yang.   

  1. Affiliated Hospital of Chengde Medical College,Chengde 067000,Chna

  • Online:2022-02-25 Published:2022-02-25
  • Contact: YANG Yang E⁃mail:yydpj1976@163.com

摘要:

目的 探讨间隙平衡法和测量截骨法两种不同截骨方式对全膝关节置换术(TKA)患者下肢力线和软骨退变的影响。方法 选取 2019 年 1 月至 2021 年 4 月我院 97 例拟行 TKA 患者,随机数字表法分为采取间隙平衡法的间隙组(n = 49),采取测量截骨法的测量组(n = 48)。比较两组围术期指标、下肢力线指标、软骨退变指标、创伤应激指标、视觉模拟评分法(VAS)、美国纽约特种外科医院(HSS)膝关节评分、并发症情况。结果 间隙组股骨远端截骨量、聚乙烯衬垫厚度大于测量组(P < 0.05);(2)术后 3 d 两组血清 Cor、NE 水平均高于术前(P < 0.05);(3)术后 1、3 个月间隙组 OPG、PANKL 水平低于测量组(P <0.05);(4)术后 1、3 个月间隙组 mMPTA、mLDFA、ROM 高于测量组(P < 0.05);(5)术后 1、3 个月间隙组VAS 评分低于测量组,HSS 评分高于测量组(P < 0.05);(6)两组并发症总发生率比较,差异无统计学意义(P > 0.05)。结论 间隙平衡法在下肢力线、软骨退变、疼痛及膝关节功能恢复方面效果优于测量截骨法,尤适用于TKA 患者。

关键词:

全膝关节置换术, 间隙平衡法, 测量截骨法, 下肢力线, 软骨退变, 假体松动

Abstract:

Objective To investigate the effect of two different osteotomy methods on lower limb align⁃ment and cartilage degeneration in patients with total knee arthroplasty(TKA). Methods From January 2019 toApril 2021,97 patients in our hospital who were scheduled to undergo TKA were selected and randomly dividedinto a gap group(n = 49)and a measurement group(n = 48)by random number table. Bone method. Perioperativeindicators,lower limb alignment indicators,cartilage degeneration indicators,trauma stress indicators,visualanalogue scale(VAS),New York Hospital for Special Surgery(HSS)knee joint score,and complications werecounted between the two groups. Results (1)The amount of distal femoral osteotomy and the thickness of thepolyethylene cushion in the gap group were greater than those in the measurement group(P < 0.05);(2)SerumCor and NE levels in the two groups were higher than those before surgery on the 3rd day after surgery(P < 0.05);(3)The OPG and PANKL levels in the 1 month and 3 months interval group were lower than those in the measure⁃ment group(P < 0.05);(4)MPTA and LDFA in the 1 month and 3 months interval group were lower than thosein the measurement group,and ROM was higher than that in the measurement group(P < 0.05);(5)VAS scoresin the 1 month and 3 months interval group were lower In the measurement group,the HSS score was higher thanthat in the measurement group(P < 0.05);(6)There was no statistically significant difference in the total inci⁃dence of complications between the two groups(P > 0.05). Conclusion The gap balance method is better thanthe measurement osteotomy method in terms of lower limb force line,cartilage degeneration,pain and knee functionrecovery,and it is especially suitable for patients with TKA.

Key words:

total knee replacement, gap balance method, measurement of osteotomy, lower limbforce line, cartilage degeneration, prosthesis loosening