全膝关节置换术两种股骨假体定位的比较Comparison of two kinds of femoral component positioning in total knee arthroplasty
陈佳晖,李彪,杨毅,李正刚,魏树发,梁一鸣,刘俊洪
摘要(Abstract):
[目的]探讨应用陀螺仪股骨髓外定位截骨行全膝关节置换的可行性及临床疗效。[方法]回顾性分析2019年3月—2020年1月行初次全膝关节置换的53例患者(61膝)的临床资料,其中27例使用陀螺仪髓外定位股骨侧截骨行全膝关节置换术(髓外组),34例行传统髓内导向杆定位股骨侧截骨全膝关节置换术(髓内组),比较两组临床疗效。[结果]所有患者均顺利完成手术,髓外组的手术时间、股骨截骨时间均少于髓内组(P<0.05);髓外组的术中失血量、术后引流量均少于髓内组(P<0.05)。两组患者术后3个月膝关节KSS评分差异无统计学意义(P>0.05)。两组患者术前、术后的髋膝踝角及术前、术后股胫角差异均无统计学意义(P>0.05)。[结论]全膝关节置换陀螺仪股骨髓外定位截骨疗效较好,能减少手术时间,降低术中失血量和术后引流量。
关键词(KeyWords): 全膝关节置换术;髓外定位;陀螺仪
基金项目(Foundation): 云南省骨关节疾病临床医学中心基金资助项目(编号:ZX-2019-03-04)
作者(Author): 陈佳晖,李彪,杨毅,李正刚,魏树发,梁一鸣,刘俊洪
参考文献(References):
- [1] Richmond J, Hunter D, Irrgang J, et al. American Academy of Orthopaedic Surgeons clinical practice guideline on the treatment of osteoarthritis(OA)of the knee[J]. J Bone Joint Surg Am, 2010,92(4):990-993.
- [2]高玉镭,李佩佳.人工关节置换相关脂肪栓塞的进展[J].中国矫形外科杂志, 2012, 20(7):629-631.
- [3]杨滨,张克,袁亮,等.新型3D打印个体导向器在膝关节置换中的应用[J].中国矫形外科杂志, 2021, 29(1):75-78.
- [4]徐志宏,徐嘉诚,陈东阳,等.全膝关节置换术股骨髓外定位系统的研制及初步临床应用[J].中华骨科杂志, 2016, 36(15):955-963.
- [5]周宗科,翁习生,曲铁兵,等.中国髋、膝关节置换术加速康复——围术期管理策略专家共识[J].中华骨与关节外科杂志,2016, 9(1):1-9.
- [6]彭慧明,翁习生.人工髋、膝关节置换术应用的原则与策略[J].骨科临床与研究杂志, 2019, 4(6):321-324.
- [7] Ma J, Huang Z, Shen B, et al. Blood management of staged bilateral total knee arthroplasty in a single hospitalization period[J]. J Orthop Surg Res, 2014, 9(1):116.
- [8] Moo IH, Chen JYQ, Pagkaliwaga EH, et al. Bone wax is effective in reducing blood loss after total knee arthroplasty[J]. J Arthroplasty, 2017, 32(5):1483-1487.
- [9] Majkowski RS, Bannister GC, Miles AW. The effect of bleeding on the cement-bone interface. An experimental study[J]. Clin Orthop, 1994, 299(299):293-297.
- [10] He S, Zhang Y, Lv N, et al. The effect of bone cement distribution on clinical efficacy after percutaneous kyphoplasty for osteoporotic vertebral compression fractures[J]. Medicine(Baltimore),2019, 98(50):e18217.
- [11] Howell SM, Hodapp EE, Vernace JV, et al. Are undesirable contact kinematics minimized after kinematically aligned total knee arthroplasty? An intersurgeon analysis of consecutive patients[J].Knee Surg Sports Traumatol Arthrosc, 2013, 21(10):2281-2287.
- [12]张子安,张海宁,李海燕,等.机器人辅助技术在全膝关节置换手术中的应用[J].中国矫形外科杂志, 2020, 28(11):937-941.