摘要
目的比较全膝关节置换术行股骨远端髓外定位与髓内定位截骨术后X线影像学评估。方法回顾性分析大理大学第一附属医院关节外科收治的12例行双侧人工全膝关节置换术的患者病例资料。膝骨关节炎并其手术由同一组医生完成的患者纳入本研究,膝关节重度内、外翻和重度屈曲畸形,膝关节外畸形患者均未纳入研究。每位患者一侧用股骨远端髓内定位截骨,另一侧用股骨远端髓外定位截骨,按定位方式将其分为:髓内定位组与髓外定位组。术后,利用X线影像上测量的髋-膝-踝角(HKA),股骨力线角、股骨屈曲角作为评价依据,比较两种方法的术后结果,用配对t检验作数据的统计分析。结果髓外定位组与髓内定位组在术后影像学评估中的HKA角(179.5±0.8)°vs(179.0±1.2)°(t=-0.995),股骨力线角(89.5±0.8)°vs(89.0±1.2)°(t=-0.980),股骨屈曲角(3.2±0.7)°vs(2.8±0.8)°(t=-2.019),差异均无统计学意义(P>0.05)。结论利用股骨远端髓外定位截骨与股骨远端髓内定位截骨行全膝关节置换术,术后测量其HKA角、股骨力线角、股骨屈曲角的X线影像学评估无显著差异。
Objective To compare the postoperative effect of total knee arthroplasty between the new model of distal femoral extramedullary positioning and intramedullary localization osteotomy. Methods Twelve cases of bilateral total knee arthroplasty in joint surgery department of the First Affiliated Hospital of Dali University had been retrospective analyzed. Those patients who had knee osteoarthritis and the operations were performed by the same group of doctors,had been included in the present study,while all the patients whose knee joints were severe varus,valgus and severe flexion deformity,as well as knee deformity,had been excluded. The distal femurs of each patient accepted traditional intramedullary positioning osteotomy on one side,the extramedullary positioning osteotomy on the other side. According to the localization,the cases were devided into two groups： the traditional group（ intramedullary positioning group） and the new type group（ extramedullary positioning group）. After the operation,the hip-kneeankle angle,femoral mechanical alignment angle and femoral flexion angle from X-ray films were measured as the evaluation criterion. The paired t test was applied for data analysis. Results There was no statistically significant difference between the traditional group and the new model group in the postoperative X-ray evaluations of the hip-knee-ankle angle（ 179. 5 ± 0. 8） ° vs（ 179. 0 ± 1. 2） °（ t = 3. 360）,femoral mechanical alignment angle（ 90. 4 ± 0. 7） ° vs（ 89. 7 ± 0. 7） °（ t = 12. 398） and femoral flexion angle（ 3. 2 ± 0. 7） ° vs（ 2. 8 ± 0. 8） °（ t = 12. 398）（ all P〈0. 05）. Conclusion The extramedullary positioning osteotomy can achieve the same postoperative radiographic evaluation results as the traditional method,and the technique is expected to be applied in total knee arthroplasty.
出处
《中华关节外科杂志（电子版）》
CAS
2017年第5期88-92,共5页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
关节成形术
置换
膝
截骨术
X线
Arthroplasty,replacement,knee
Osteotomy
X-ray
