不同类型膝关节假体对初次单侧膝关节置换患者术后患肢功能恢复效果的影响

蒲超 张珊珊 白亦光 李伟 吴青霞 吴辉

[摘要] 目的 比較不同类型膝关节假体对初次单侧膝关节置换患者术后患肢功能恢复的影响。 方法 选择2014年 1月～2016年6月川北医学院第二临床学院初次行单侧膝关节置换术的患者350例，根据不同膝关节假体分为A组（旋转平台，180例）和B组（后稳定固定平台，170例）。比较两组术前、术后6个月美国膝关节学会（HSS）评分、世界膝关节学会（KSS）评分、膝关节屈曲度（ROM）及静态稳定性指标，记录两组并发症情况。 结果 与术前比较，两组术后6个月HSS评分、KSS评分、ROM均显著上升，横轴向GCP偏移位置、GCP漂移轨迹均显著减少，差异有统计学意义（P < 0.05）；A组术后6个月GCP漂移轨迹显著小于B组（P < 0.05），其他指标差异均无统计学意义（P > 0.05）；两组总并发症发生率比较，差异无统计学意义（P > 0.05）。 结论 旋转平台与后稳定固定平台假体均能明显促初次单侧膝关节置换患者术后患肢功能恢复，并发症类似，但前者相对静态稳定性更好。

[关键词] 单侧膝关节置换术；旋转平台假体；后稳定固定平台假体；患肢功能；静态稳定性

[中图分类号] R687.4 [文献标识码] A [文章编号] 1673-7210（2018）05（c）-0076-04

Influence of different types of knee prostheses on limb function recovery after initial unilateral knee replacement

PU Chao1 ZHANG Shanshan2 BAI Yiguang1 LI Wei1▲ WU Qingxia1 WU Hui1

1.Department of Orthopaedics， the Second Clinical College of North Sichuan Medical College Nanchong Central Hospital， Sichuan Province， Nanchong 637000， China； 2.Neurology Department， the Second Clinical College of North Sichuan Medical College， Nanchong Central Hospital， Sichuan Province， Nanchong 637000， China

[Abstract] Objective To compare the influence of different types of knee prostheses on limb function recovery after initial unilateral knee replacement. Methods Form January 2014 to June 2016， in Second Clinical College of North Sichuan Medical College， according to different knee prostheses， 350 patients underwent initial unilateral knee replacement in the were divided into group A （rotating platform， 180 cases） and group B （posterior stabilized platform， 170 cases）. The American Knee Association （HSS） scores， the world Knee Society Association （KSS） scores， knee flexion （ROM） and static stability indexes were compared in the two groups before operation and after the operation 6 months. The incidence of complications in the two groups was recorded. Results After operation 6 months， HSS scores， KSS scores and ROM significantly increased， the horizontal offset of GCP to GCP and GCP trajectory significantly decreased， the differences were statistically significant （P < 0.05）. 6 months after operation， GCP trajectory in group A was significantly shorter than group B， the differences were statistically significant （P < 0.05）， but there was no significant difference in other indicators between two groups （P > 0.05）. There was no significant difference in the incidence of complications between the two group （P > 0.05）. Conclusion Both of rotating platform and posterior stabilized platform prostheses can significantly promote limb function recovery in patients undergoing initial unilateral knee replacement. The complications are similar but the static stability of the former is relatively better.

[Key words] Unilateral knee replacement； Rotating platform prosthesis； Posterior stabilized platform prosthesis； Limb function； Static stability

膝关节病好发于老年人群，其功能破坏在很大程度上影响人体站立或行走。目前人工膝关节置换术在膝关节骨关节炎治疗中应用较多且效果令人满意，能有效改善患者平衡功能，促患肢功能恢复[1]。近年来随着医疗技术的进步，膝关节假体材料不断更新、种类较多，如旋转平台型假体（PFC-RP）、固定平台型假体（PFC-Sigma）、高屈曲度假体、内轴型假体、后稳定型假体等，各有优劣[2-5]。杨光洲等[6]研究发现固定与旋转膝关节假体治疗退行性骨关节炎早期疗效相当。谢……