摘要
目的对比观察老年骨关节炎患者人工关节置换术中所见与临床表现的关系。方法选择2001年1月～2005年6月老年骨关节炎行全膝关节表面置换患者150例（182膝），①收集X线片，记录膝关节面的破坏情况、关节间隙狭窄程度、骨赘形成的部位及数量；②部分行MRI检查，记录膝关节内纤维软骨的改变、半月板的位置。将其结果对比术中所见。结果150例中内翻畸形108例，内翻角平均12．5°（0°～25°）；外翻畸形21例，外翻角平均18．3°（15°～25°）；单纯屈曲挛缩畸形21例，平均15．3°（0°～40°）。行人工关节表面置换的150例病膝中X线均有膝关节间隙不同程度狭窄、间隙不均的表现，131例152膝后缘或侧方有骨赘、游离体形成。行MRI检查的11例15膝中，图像显示纤维软骨下不连续，囊性变，关节面纤维软骨磨损，间室破坏。内外侧半月板出现侧后方脱位。手术中可见间隙狭窄侧胫股关节面纤维软骨磨损严重，侧副韧带挛缩，胫、股骨后方骨赘、游离体存在，关节间隙纤维软骨磨损侧半月板磨损或向侧后方脱位。结论老年骨关节炎除以疼痛、关节功能障碍为临床表现外，仍有膝关节力线改变，关节软组织挛缩，游离体、骨赘形成，关节间隙狭窄，股骨髁远端及胫骨平台关节面纤维软骨损害，半月板磨损或向侧后方脱位的综合表现。
Objective To study the relationship between intraoperative findings during knee joint replacement and clinical manifestations in elderly patients with knee osteoarthritis. Methods A total of 150 cases of senile knee osteoarthritis （182 knee joints） was selected for total knee replacement. Their X-ray examination results were gathered for recording the impairment of the articular surface, the joint space narrowing, and the location and amount of osteophytes. An MRI examination was performed in some of the cases for recording changes of fibroeartilage and locations of meniscus. Results Out of the 150 cases, there were 108 cases of genu varum （mean inversion angle, 12.5°; range, 0°～25°） , 21 cases of genu valgum （mean eversion angle, 18.3°; range, 15°～25°）, and 21 cases of flexion eontraeture （mean angle, 15.3~; range, 0°～40°）. The X-ray findings showed varying degrees of joint space narrowing in all the 150 cases, and osteophytes on the posterior border or at lateral part of the knee joint in 131 cases （152 joints）. MRI examinations were performed in 11 cases （15 joints）, in which discontinuous, cystoid, and worn-out fibroeartilages were seen. Radial displacement of the meniscus was found. Intraoperative findings proved that the fibroeartilage on the articular surface on the side with joint space narrowing was severely worn away, the collateral ligaments were contracted, the osteophytes were seen at the posterior part of the tibia and the femur, and abrasion or radial displacement of the meniscus on the side with joint space narrowing. Conclusions Joint space narrowing, varus or valgus deformity, osteophytes, and radial displacement of the meniscus are usually found in aged patients with knee osteoarthritis.
出处
《中国微创外科杂志》
CSCD
2006年第10期780-782,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
老年
骨关节炎
人工关节置换
Aged
Osteoarthritis
Artificial joint replacement
