摘要
人工全膝置换治疗膝内翻畸形已成为膝内翻畸形外科治疗的主要方式之一,但膝关节内翻畸形的患者行人工全膝关节置换的难度较大,尤其是在软组织生物力学方面的争议较多。为更好地评估人工全膝置换治疗膝内翻畸形的生物力学性能,文章应用计算机检索PubMed数据库检索2006/2008关于膝关节置换治疗膝内翻方面的文章,检索词"TKA,Varvsknee",对资料进行初审,选取符合实验要求的有关文章进行总结分析。结果显示对于严重的膝内外翻畸形和屈曲畸形的患者,软组织松解平衡应有计划、分步骤地进行,每完成一步都要进行测量,要做到既纠正到位,又不可过度纠正造成关节继发不稳定。股骨、胫骨要求对线准确,保证假体置入后股骨头中心、膝关节中心和踝关节中心位于一直线。同时又回顾性分析了2000-01/2006-07河南省南阳市骨科医院膝内翻畸形骨关节炎患者人工全膝置换后43例患者的临床结果,并采用KSS评分对临床结果进行评估,其中5例失访,38例46膝获完整随访,平均随访5年。术前至最后1次随访,均膝关节功能评分27(12～55)分/77(56～98)分;92%的患者膝关节活动度超过90°多数病例术后膝关节力线正常,4例残留5°～10°内翻畸形。
Total knee arthroplasty （TKA） has become a major surgical treatment for knee varus deformity. However, it is a risk to perform TKA for patients with knee varus deformity, in particular in biomechanics of soft tissues. To better evaluate the biomechanical performance of TKA for knee varus deformity, related papers were searched with the key words of TKA, varus knee For patients with severe knee varus deformity and flexion deformity, soft tissue release should be performed step by step. Measurement should be done after each step to properly correct the deformity and avoid secondary instability. Alignment of the femur and tibia should be correct to ensure the center of the femoral head, knee joint and ankle joint at the same line. In addition, clinical results of 43 patients with osteoarthritis who underwent TKA in Nanyang Hospital of Orthopedics between January 2000 and July 2006 were analyzed and evaluated by KSS scored. Of them, 5 lost the follow up, and 38 patients （46 knees） were followed up for average of 5 years. The knee joint function scores were 27（12-55） to 77（56-98） points preoperatively to the final follow up visit. The range of joint motion exceeded 90° in 92% of the patients, and most of the patients had normal line of force of the knee joint, but 4 patients remained varus deformity of 5°-10°.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第9期1715-1718,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
