摘要
目的探讨股骨假体套筒翻修术治疗旋转铰链膝关节股骨假体聚乙烯套筒磨损的临床疗效。方法回顾性分析2008年8月至2023年4月在中国人民解放军总医院第四医学中心骨科医学部治疗的旋转铰链型膝关节股骨假体聚乙烯套筒磨损患者21例,男8例、女13例,年龄63(38,76)岁,左侧11例、右侧10例,体质指数为25.0(22.5,31.0)kg/m^(2),均为单侧膝关节翻修。接受铰链型膝关节假体至翻修的时间间隔为10.5(6.0,17.0)年,其中18例为初次翻修、3例为再次翻修。所有患者均因股骨假体聚乙烯套筒磨损而接受股骨假体套筒翻修术治疗。收集并记录患者视觉模拟评分(visual analogue scale,VAS)、膝关节活动范围(range of motion,ROM)、髋膝踝角(hip-knee-ankle angle,HKA)变化程度和美国膝关节协会评分(Knee Society score,KSS)评估手术效果。结果所有患者均获得随访,随访时间为12.5(11.7,13.4)个月。术前VAS评分为5(3,7分),末次随访时减小至0(0,1)分,差异有统计学意义(Z=5.721,P<0.001)。末次随访时,KSS评分由术前的(41.19±13.65)分降至(79.81±7.80)分,差异有统计学意义(t=12.560,P<0.001);HKA由术前的174.65°±5.20°提高至178.71°±2.79°,差异有统计学意义(t=5.533,P<0.001);膝关节ROM由术前的69.05°±34.37°增加至110.00°±10.12°,差异有统计学意义(t=5.960,P<0.001);患者膝关节稳定,无被动屈伸松弛。结论股骨假体套筒翻修术治疗旋转铰链膝关节股骨假体聚乙烯套筒磨损可避免整体翻修造成的大量骨与软组织丢失,术后早期临床疗效满意。
Objective To investigate the clinical efficacy of femoral component revision surgery in addressing polyethylene sleeve wear in rotating hinge knee joints.Methods A retrospective analysis was conducted on 21 patients who underwent treatment for polyethylene sleeve wear in rotating hinge knee joints at the Department of Orthopaedics,the Fourth Medical Center,PLA General Hospital,spanning from August 2008 to April 2023.There were 8 males and 13 females with a median age of 63(38,76)years.Among them,11 cases involved the left side,and 10 cases involved the right side.The average body mass index(BMI)was 25.0(22.5,31.0)kg/m2,and all cases underwent unilateral knee joint revision.The time interval from receiving the hinge knee joint prosthesis to revision was 10.5(6.0,17.0)years,with 18 cases undergoing primary revision and 3 cases undergoing revision for the second time.Revision surgery of the femoral component sleeve was performed in all patients due to polyethylene sleeve wear.Visual analogue scale(VAS),range of motion(ROM)of the knee joint,changes in hip-knee-ankle angle(HKA),and Knee Society score(KSS)were collected and recorded to assess the surgical outcomes.Results All patients were followed up for a median duration of 12.5(11.7,13.4)months.Preoperatively,the VAS score was 5(3,7)points,which significantly decreased to 0(0,1)points at the last follow-up(Z=5.721,P<0.001).At the last follow-up,the KSS scores decreased from 41.19±13.65 points preoperatively to 79.81±7.80 points,indicating a statistically significant difference(t=12.560,P<0.001).HKA increased from 174.65°±5.20°preoperatively to 178.71°±2.79°,with a statistically significant difference(t=5.533,P<0.001).Knee joint ROM increased from 69.05°±34.37°preoperatively to 110.00°±10.12°,also demonstrating a significant improvement(t=5.960,P<0.001).Notably,patients exhibited knee joint stability with no passive flexion or extension laxity.Conclusion Femoral component sleeve revision surgery effectively addresses polyethylene sleeve wear in rotating
作者
陶冶
付君
胡瀚文
郑清源
陈继营
倪明
Tao Ye;Fu Jun;Hu Hanwen;Zheng Qingyuan;Chen Jiying;Ni Ming(Department of Orthopaedics,the Fourth Medical Center of Chinese PLA General Hospital,Beijing 100048,China)
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2024年第4期210-216,共7页
Chinese Journal of Orthopaedics
基金
海淀重点研究专题(L222032)。
关键词
关节成形术
置换
膝
再手术
假体设计
Arthroplasty,replacement,knee
Reoperation
Prosthesis design
