摘要
目的探讨术前下肢对线畸形对人工膝关节表面置换术（total knee arthroplasty,TKA）中假体安装角度以及术后下肢对线的影响。方法回顾分析2012年1月-2013年12月198例（245膝）因退行性骨关节炎行初次TKA患者的临床资料。男23例,女175例;年龄43-90岁,平均67岁。单膝151例,双膝47例。病程1个月-30年,中位时间8.99年。于下肢全长正位X线片测量术前及术后1周股骨与胫骨机械轴线夹角（femorotibial angle,FT）,分别代表手术前后下肢对线角度;术后1周股骨机械轴线与关节线夹角（mechanical femoral angle,MF）、胫骨机械轴线与关节线夹角（anatomical tibial angle,AT）,分别代表股骨、胫骨假体安装角度。对手术前后FT及MF、AT进行相关分析。根据术前下肢对线畸形程度将患者分为5组：内翻畸形≥20°组（A组）、内翻畸形10-20°（B组）、内翻畸形≤10°（C组）、外翻畸形〈10°（D组）、外翻畸形≥10°（E组）,对各组以上指标进行统计分析,并记录术后下肢对线优良率。结果 245膝手术前后FT分别为（171.53±9.12）、（177.38±3.57）°,术后MF及AT分别为（89.00±2.68）、（88.62±2.16）°。术前FT与术后FT及MF相关（r=0.375,P=0.000;r=0.386,P=0.000）,与AT无相关（r=0.024,P=0.710）。术后FT与MF、AT亦相关（r=0.707,P=0.000;r=0.582,P=0.000）。各组组内术后FT与术前比较,差异有统计学意义（P〈0.05）。各组术前FT比较差异均有统计学意义（P〈0.05）;术后A组与B、C、D、E组比较,B、C组分别与D、E组比较,差异均有统计学意义（P〈0.05）;B、C组间及D、E组间比较,差异无统计学意义（P〉0.05）。总体术后下肢对线优良率为70.2%（172/245）,A、B、C、D、E组分别为27.8%（5/18）、66.0%（62/94）、74.4%（67/90）、88.9%（32/36）、85.7%（6/7）;各组间下肢对线优良率比较,差异有统计学意义（P〈0.05）。各组间AT比较,差异均无统计学意义（P〉0.05）�
Objective To investigate the effect of preoperative valgus or varus deformity on the prosthesis installation and alignment restoration in total knee arthroplasty（TKA）. Methods Between January 2012 and December 2013, 198 patients（245 knees） with osteoarthritis underwent primary TKA, and the clinical data were retrospectively analyzed. There were 23 males and 175 females, with the average age of 67 years（range, 43-90 years）. Single knee and double knees were involved in 151 and 47 cases respectively. The disease duration was from 1 month to 30 years（mean, 8.99 years）. The anteroposterior X-ray films of whole lower limbs were taken, and the femorotibial angle（FT） was measured before operation and at 1 week after operation; the mechanical femoral angle（MF） and the anatomical tibial angle（AT） at 1 week after operation were measured. The correlation analysis was made for pre- and post-operative FT, MF, and AT. According to the valgus or varus deformity before operation, all patients were divided into 5 groups： ≥ 20° varus（group A）, 10-20° varus（group B）, ≤ 10° varus（group C）, 〈10° valgus（group D）, and ≥ 10° valgus（group E）, and the above indicators were compared between groups. And the rate of the good limb alignment was recorded after operation. Results The pre- and post-operative FT were（171.53±9.12） and（177.38±3.57）° respectively, and postoperative MF and AT were（89.00±2.68） and（88.62±2.16）° respectively. Preoperative FT was associated with postoperative FT and MF（r=0.375, P=0.000; r=0.386, P=0.000）, but it was not correlated with AT（r=0.024, P=0.710）. Postoperative FT was associated with MF and AT（r=0.707, P=0.000; r=0.582, P=0.000）. Postoperative FT was significantly increased when compared with preoperative FT in each group（P〈0.05）. There were significant differences in preoperative FT between groups（P〈0.05）. There were significant differences in postoperative FT when compared group A with groups B, C, D,
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2016年第3期368-372,共5页
Chinese Journal of Reparative and Reconstructive Surgery
基金
国家自然科学基金资助项目(81171759)
广东省自然科学基金资助项目(2014A030313185
2015A030310207)
广东省科技计划项目(2013B02180119)~~
