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-  2017 

人工全膝关节置换术中采用骨水泥联合螺钉修复胫骨平台骨缺损的近期疗效

DOI: doi:10.7507/1002-1892.201704016

Keywords: 人工全膝关节置换术, 胫骨平台, 骨缺损, 骨水泥, 螺钉

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Abstract:

目的 总结人工全膝关节置换术(total knee arthroplasty,TKA)中采用骨水泥联合螺钉修复胫骨平台骨缺损的近期疗效。 方法 2013 年 3 月—2016年 3 月,对 30 例行初次 TKA 患者术中采用骨水泥联合螺钉修复胫骨平台骨缺损。男 8 例,女 22 例;年龄 55~71 岁,平均 64.7 岁。左膝 17 例,右膝 13 例。骨关节炎 22 例,类风湿性关节炎 8 例。病程 9~27 个月,平均 14 个月。膝关节学会评分系统(KSS)评分为(41.63±6.76)分,美国特种外科医院(HSS)评分为(38.10±7.00)分。膝内翻畸形 19 例,膝外翻畸形 11 例。胫骨平台骨缺损根据 Rand 分型标准,均为Ⅱb 型。 结果 术后切口均Ⅰ期愈合,无感染、下肢深静脉血栓形成等并发症发生。患者均获随访,随访时间 10~42 个月,平均 27.5 个月。末次随访时,HSS 评分为(90.70±4.18)分、KSS 评分为(93.20±3.75)分,与术前比较差异均有统计学意义(t=–58.014,P=0.000;t=–60.629,P=0.000)。X 线片复查示,均未出现假体下沉、骨溶解、骨吸收、螺钉松动、骨水泥断裂等并发症。 结论 TKA 术中采用骨水泥联合螺钉修复严重膝内、外翻并发的胫骨平台骨缺损,简便、安全,近期疗效较好

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