摘要
目的观察国产A3高屈曲后稳定型假体的中期疗效,并与一款同期的进口人工关节进行对照研究。方法回顾性分析2012年6月至2013年12月在北京大学第三医院骨科初次行全膝关节置换(TKA)治疗的342例(共438膝)终末期膝骨关节炎患者的临床资料。手术均经同一医师完成。将患者按照假体类型分为2组:国产组,采用国产A3假体107例(137膝);对照组,采用进口GenesisⅡ假体235例(301膝)。最终311例(390膝)获得完整随访,对2组患者的术后最大屈曲角度、术后西安大略和麦马斯特大学骨性关节炎指数(WOMAC评分)以及美国特种外科医院膝关节评分(HSS评分)、下肢冠状面力线恢复情况及住院情况进行比较分析。同组患者手术前后计量数据比较采用配对t检验,不同组比较采用独立样本t检验。结果所有患者平均随访时间(5.6±1.1)年,国产组平均64.8个月,对照组68.2个月。两组术后3个月及随访终点的HSS和WOMAC评分、膝关节最大屈曲角度、下肢冠状面力线恢复情况差异均无统计学意义(t=-0.890、-1.610、1.740、0.620,均P>0.05)。2012年国产组总住院费用(24879±1627)元,对照组为(49611±1589)元,差异有统计学意义(t=-48.902,P<0.01);2013年国产组为(38393±2773)元,对照组为(55931±3533)元,差异亦有统计学意义(t=-14.795,P<0.01)。结论国产A3假体全膝关节置换术后中期临床疗效满意,与进口假体相比无显著性差异,能显著降低治疗费用。
Objective To observe the mid-term clinical outcome of total knee arthroplasty ( TKA) with domestic A3 posterior stabilized prosthesis .Methods The clinical data of 342 patients ( 438 knees ) who underwent primary TKA by the same surgeon from June 2012 to December 2013 in Peking University Third Hospital were retrospectively collected .The patients were divided into 2 groups according to the type of prosthesis:107 patients (137 knees) with domestic A3 prosthesis, as domestic group; 235 patients (301 knees) with a kind of imported prosthesis, as the control group.In the end, 311 patients (390 knees) received complete follow-up.The postoperative knee maximum flexion angle , postoperative Hospital for Special Surgery Knee Score ( HSS) and the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) , postoperative coronal mechanical axis alignment and hospitalization costs were compared between the groups.Paired t-test was used to compare the preoperative and postoperative data in the same group, and independent sample t-test was used to compare the data between the two groups at the same time points.Results The average follow-up time of all the patients was (5.6 ±1.1) years, and it was averaged for 64.8 months in the domestic group and 68.2 months in the control group.There was no significant difference in the HSS score and WOMAC score , the knee maximum flexion angle , and coronal mechanical axis alignment at the 3 months postoperatively and at the end of follow-up between the two groups ( t =-0.890, -1.610, 1.740, 0.620, all P >0.05 ) .In 2012, the average hospital cost was ( 24879 ± 1627) yuan/knee in the domestic group and it was (49611 ±1589) yuan/knee in the control group (t=-48.902, P<0.01 ) .In 2013, it was ( 38393 ±2773 ) yuan/knee in the domestic group , and was (55931 ±3533) yuan/knee in the control group (t=-14.795, P<0.01).Conclusion It indicates that the domestic A3 posterior stabilized prosthesis brings comparable mid-term results with the imported prothesis and it reduces medical
作者
耿霄
田华
李杨
赵旻暐
王鑫光
梁宇鹏
张克
刘忠军
Geng Xiao;Tiaa Hua;Li Yang;Zhao Minwei;Wang Xinguang;Liang Yupeng;Zhang Ke;Liu Zhongjun(Department of Orthopedics,Peking University Third Hospital,Beijing 100191,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2018年第47期3873-3877,共5页
National Medical Journal of China
关键词
膝关节置换术
国产假体
疗效
Total knee arthroplasty
Domestic prosthesis
Outcome
