摘要
背景:既往倾向于研究单髁关节置换术后最佳胫骨平台后倾角,忽略了与术前角度进行对比,探究其变化程度对临床疗效的影响。目的:探讨在接受单髁关节置换后,胫骨平台后倾角的变化情况及对短期疗效的影响。方法:选择2016年1月至2021年6月于徐州医科大学附属医院因内侧骨性关节炎行单髁关节置换的患者65例(67膝)为研究对象,依据术后减去术前胫骨平台后倾角的差值进行分组,正值为后倾增大,负值为后倾减小;A组后倾减小>2°,B组后倾变化≤2°,C组后倾增大>2°。记录3组患者术前、术后末次随访的美国特种外科医院膝关节评分、牛津膝关节评分、膝关节活动度及人工关节遗忘指数,并进行对比。结果与结论:(1)此次研究共纳入65例(67膝),根据胫骨平台后倾角变化情况进行分组,A组13膝、B组38膝、C组16膝;(2)3组病例在年龄、性别及假体型号大小等基线资料上差异均无显著性意义(P>0.05);(3)术后末次随访膝关节活动度比较,C组膝关节活动度显著大于A组(P=0.014)和B组(P=0.032);(4)B组末次随访牛津膝关节评分显著低于C组(P=0.004);(5)在末次随访人工关节遗忘度指数上,B组显著优于A组(P=0.012);(6)提示单髁关节置换后胫骨平台后倾角变化≤2°的患者术后近期临床疗效较好,单髁置换过程中应当注重胫骨侧个体化、精确化截骨。
BACKGROUND:Previous studies have tended to study the optimal posterior tibial slope of tibial plateau after unicompartmental knee arthroplasty,ignoring the comparison with the preoperative angle to explore the impact of the degree of change on the clinical efficacy.OBJECTIVE:To investigate the changes of posterior tibial slope and their influence on short-term efficacy after unicompartmental knee arthroplasty.METHODS:Totally 65 patients(67 knees)who underwent Oxford unicompartmental knee arthroplasty for medial osteoarthritis in Affiliated Hospital of Xuzhou Medical University from January 2016 to June 2021 were selected as the research subjects.The groups were divided according to the difference between postoperative minus preoperative posterior tibial slope.Positive value was increased posterior slope;negative value was decreased posterior slope.Group A:posterior slope decreased>2°,Group B:posterior slope changed≤2°,Group C:posterior slope increased>2°.The hospital for special surgery knee score,Oxford knee score,range of motion,and forgotten joint score were recorded and compared in three groups.RESULTS AND CONCLUSION:(1)A total of 65 patients(67 knees)were included in this study.According to the change of the average posterior tibial slope,they were divided into three groups,with 13 knees in group A,38 knees in group B,and 16 knees in group C.(2)There was no significant difference in baseline data such as age,gender and prosthesis size among the three groups(P>0.05).(3)Compared with the knee range of motion at the last follow-up after operation,the knee range of motion in group C was significantly greater than that in group A(P=0.014)and group B(P=0.032).(4)The Oxford knee score of group B at last follow-up was significantly lower than that of group C(P=0.004).(5)In the last follow-up,artificial joint amnesia index in the group B was significantly better than that in the group A(P=0.012).(6)It is indicated that patients with a change in posterior tibial slope of≤2°after unicompartmental knee arthropla
作者
胡正浩
陈旺
冯硕
张乐曙
陈向阳
Hu Zhenghao;Chen Wang;Feng Shuo;Zhang Leshu;Chen Xiangyang(Department of Joint Surgery,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2023年第18期2854-2860,共7页
Chinese Journal of Tissue Engineering Research
