全膝表面置换治疗膝骨性关节炎合并胫骨平台骨缺损
符东林;干阜生;王宏亮;聂宇;郭标;潘檀;崔西龙;
摘要(Abstract):
[目的]探讨骨性关节炎合并胫骨平台骨缺损在全膝表面置换术中的处理方法。[方法]膝关节骨性关节炎内翻畸形伴胫骨平台骨缺损22例27膝行全膝表面置换术,分别记录手术前后膝关节内翻畸形程度,HSS评分,活动范围,并进行比较。[结果]所有患者均获得平均(27.6±7.2)个月(6个月~6年)随访,膝关节HSS评分由术前的45.6分提高到末次随访时的平均89.7分,下肢畸形及关节功能明显改善。[结论]胫骨平台骨缺损性膝关节骨性关节炎行TKA,对骨缺损行有效处理和植骨可取得良好疗效。
关键词(KeyWords): 膝关节骨性关节炎;胫骨平台骨缺损;全膝表面置换术;植骨
基金项目(Foundation):
作者(Author): 符东林;干阜生;王宏亮;聂宇;郭标;潘檀;崔西龙;
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参考文献(References):
- [1]Insall JN,Dorr LD,Scott RD,et al.Rationale of the knee society clinical rating system[J].Clin Orthop,1989,248:13-14.
- [2]Rand JA.Bone deficiency in total knee arthroplasty:use of metal wedge a ugmentation[J].Clin Orthop,1991,271:63-71.
- [3]Ritter MA,Faris GW.Total knee arthroplasty in patients with angular varus or valgus deformities of>or=20 degrees[J].J Arthroplasty,2004,7:862-866.
- [4]Troyer J,Levine BR.Proximal tibial reconstruction with tantalum cone in a patient with Charcot arthropathy[J].Orthopedics,2009,5:359-563.
- [5]Lotke PA,Carolan GF,Puri N.Impaction grafting for bone defects in revision total knee arthroplasty[J].Clin Orthop,2006,446:99-103.
- [6]Dennis DA,Little LR.The structural allograft composite in revision total knee arthroplasty[J].Orthopedics,2005,28:1005-1007.
- [7]Clatwortby MG,Ballance J,Brick GW,et al.The use of structural allograft for uncontained defects in revision total knee arthroplasty.A minimum five-year review[J].J Bone Joint Surg Am,2001,83:404-411.
- [8]吕厚山,王东.全膝关节置换术中胫骨近端倾斜性骨缺损的重建[J].中华骨科杂志,2003,8:466.
- [9]卿忠,姚建锋,张育民,等.屈曲挛缩畸形全膝关节置换的软组织平衡[J].中国骨与关节损伤杂志,2013,10:923-925.
- [10]白志刚,牛东生.综合性外科疗法治疗膝关节高度屈曲畸形的临床分析[J].中国矫形外科杂志,2009,17:1297-1299.
- [11]Completo A,Simoes JA,Fonseca F,et al.The influence of different tibial stem designs in load sharing and stability at the cement-bone interface in revision TKA[J].Knee,2008,3:227-232.
- [12]张强,王岩,周勇刚.内外翻限制性假体在复杂初次膝关节置换中的应用[J].中国矫形外科杂志,2009,8:572-574.