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-  2015 

人工全膝关节置换术中应用缩小胫骨平台截骨技术矫正膝内翻畸形的疗效观察

DOI: doi:10.7507/1002-1892.20150311

Keywords: 人工全膝关节置换术, 缩小胫骨平台截骨, 膝内翻畸形, 骨关节炎

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Abstract:

目的探讨人工全膝关节置换术中应用缩小胫骨平台截骨技术矫正膝内翻畸形的疗效。 方法回顾性分析2010年5月-2012年7月,16例(24膝)人工全膝关节置换术中采用缩小胫骨平台截骨技术矫正膝内翻畸形患者临床资料。男2例(3膝),女14例(21膝);年龄57~79岁,平均67岁。病程3~15年,平均9.1年。术前膝关节学会评分系统(KSS)临床评分为(38.71±10.04)分、功能评分为(50.31±14.31)分,膝关节活动度为(91.88±13.01)°,股胫角为内翻(9.04±4.53)°。术中经缩小胫骨平台截骨后内翻畸形完全矫正。 结果手术时间85~245 min,平均165.5 min。显性失血量10~800 mL,平均183.1 mL。住院时间8~22 d,平均13.6 d。术后切口均Ⅰ期愈合,无相关并发症发生。患者均获随访,随访时间37~62个月,平均48个月。术后48 h拔除引流管后复查X线片示,膝关节股胫角为外翻(3.92±1.89)°,下肢力线均恢复正常;随访期间无假体松动、下沉。末次随访时,膝关节KSS临床评分为(84.21±6.49)分、功能评分为(85.31±6.95)分,膝关节活动度为(105.83±11.29)°,与术前比较差异均有统计学意义(t=20.665,P=0.000;t=9.585,P=0.000;t=8.333,P=0.000)。 结论对于膝关节骨关节炎伴内翻畸形患者,人工全膝关节置换术中应用缩小胫骨平台截骨技术可有效矫正内翻畸形,术后下肢力线恢复良好,膝关节活动度及功能恢复满意

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