摘要
目的 观察原发性膝骨关节炎患者行后稳定型全膝关节置换术前、后胫骨平台后倾角(posterior tibial slope,PTS)变化,探讨其对术后膝关节功能的影响。方法 219例原发性膝骨关节炎患者均行单侧初次后稳定型全膝关节置换术,分别于术前2 d、术后12个月行站立位膝关节侧位X线检查,测量PTS,计算手术前后PTS差值(△PTS)。219例患者根据△PTS均值(5.13°)分为小△PTS组87例(△PTS≤5.13°)和大△PTS组132例(△PTS>5.13°),比较2组术前2 d、术后12个月膝关节活动范围(range of motion,ROM)、疼痛视觉模拟评分(visual analogue scale,VAS)、西安大略和麦克马斯特大学骨关节炎评分(the Western Ontario and McMaster Universities Osteoarthritis index,WOMAC)、美国膝关节协会评分(American Knee Society score,KSS)。采用Pearson相关法分析行后稳定型全膝关节置换术的原发性膝骨关节炎患者△PTS与术后ROM、VAS评分、WOMAC评分、KSS评分的相关性。结果 小△PTS组术前ROM[(105.64±15.32)°]及VAS评分[(5.89±1.47)分]、WOMAC评分[(101.74±11.34)分]、KSS临床评分[(43.75±16.31)分]、KSS功能评分[(41.10±15.24)分]与大△PTS组[(106.17±16.52)°、(6.12±1.24)分、(106.39±9.28)分、(41.42±17.61)分、(39.62±14.31)分]比较差异均无统计学意义(P>0.05);术后小△PTS组、大△PTS组ROM[(121.64±11.34)°、(116.12±12.69)°]及KSS临床评分[(82.18±9.12)、(80.42±10.63)分]、KSS功能评分[(80.13±7.11)、(77.41±6.39)分]均高于术前(P<0.05),VAS评分[(1.73±1.22)、(1.66±1.41)分]、WOMAC评分[(38.86±6.94)、(42.18±7.18)分]均低于术前(P<0.05);小△PTS组术后ROM大于大△PTS组(t=1.793,P=0.017),术后VAS评分、WOMAC评分、KSS临床评分、KSS功能评分与大△PTS组比较差异均无统计学意义(P>0.05)。行后稳定型全膝关节置换术的原发性膝骨关节炎患者△PTS与术后ROM呈负相关(r=-0.634,P=0.028),与术后VAS评分、WOMAC评分、KSS临床评分、KSS功能评分均无相
Objective To observe the changes in the posterior tibial slope(PTS) before and after posterior-stabilized total knee arthroplasty in patients with primary knee osteoarthritis,and to explore its impact on postoperative knee joint function.Methods Totally 219 patients with primary knee osteoarthritis underwent unilateral posterior-stabilized total knee arthroplasty.Standing knee lateral X-ray examinations were performed 2 days before surgery and 12 months after surgery to measure PTS.The difference value of PTS before and after surgery(△PTS) was calculated.According to the mean value of △PTS(5.13°),219 patients were divided into 87 patients with △PTS≤5.13°(small △PTS group) and132 patients with △PTS>5.13°(large △PTS group).The range of motion(ROM),visual analogue scale(VAS),the Western Ontario and McMaster Universities Osteoarthritis index(WOMAC),and American Knee Society(KSS) score were compared 2 days before surgery and 12 months after surgery between two groups.Pearson correlation method was used to analyze the correlations of postoperative △PTS with ROM,VAS,WOMAC and KSS scores in primary knee osteoarthritis patients undergoing posterior-stabilized total knee arthroplasty.Results There were no significant differences in the preoperative ROM,VAS,WOMAC,KSS clinical and KSS functional scores between small △PTS group [(105.64±15.32)°,5.89±1.47,101.74±11.34,43.75±16.31,41.10±15.24] and large △PTS group[(106.17±16.52)°,6.12±1.24,106.39±9.28,41.42±17.61,39.62±14.31](P>0.05).The postoperative ROMs[(121.64±11.34)°,(116.12±12.69)°],KSS clinical scores(82.18±9.12,80.42±10.63),and KSS functional scores(80.13±7.11,77.41±6.39) in small and large △PTS groups were larger than those before surgery(P<0.05),while VAS scores(1.73±1.22,1.66±1.41),and WOMAC scores(38.86±6.94,42.18±7.18) were smaller than those before surgery(P<0.05).After surgery,the ROM in small △PTS group was larger than that in large △PTS group(t=1.793,P=0.017),and there were no significant differences in VAS,W
作者
刘晨晨
李朝成
董永辉
郑稼
LIU Chen-chen;LI Zhao-cheng;DONG Yong-hui;ZHENG Jia(Department of Orthopedics,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Zhengzhou,Henan 450003,China)
出处
《中华实用诊断与治疗杂志》
2023年第6期619-622,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省医学科技攻关计划省部共建青年项目(SBGJ202103009)。
