全膝关节置换术中股骨内髁滑移截骨治疗伴有关节外畸形的膝内翻

被引：7

作者：

陈昊 ^{[1
]}

郭林 ^{[1
]}

熊然 ^{[1
]}

古凌川 ^{[1
]}

罗江明 ^{[1
]}

杨柳 ^{[1
]}

Jean Louis Briard ^{[2
]}

机构：

[1] 第三军医大学附属西南医院关节外科中心

[2] 法国鲁昂赛德尔矫形外科中心

来源：

骨科 | 2016年 / 7卷 / 05期

关键词：

关节成形术,置换,膝; 内翻膝; 畸形; 截骨术;

D O I：

暂无

中图分类号：

R687.4 [关节手术];

学科分类号：

100220 [骨科学];

摘要：

目的探讨股骨内髁滑移截骨术(medial condyle sliding osteotomy,MCSO)在全膝关节置换术中纠正患者内翻膝关节外畸形的临床疗效。方法通过回顾性研究2013年1月至2015年12月在第三军医大学附属西南医院关节外科中心于全膝关节置换术中采用MCSO在关节内纠正股骨侧的关节外内翻畸形的12例患者,统计该组患者手术前后的股骨远端外侧力线角(mechanical lateral distal femoral angle,m LDFA)、髋-膝-踝(hip-knee-ankle,HKA)角、疼痛视觉模拟量表(visual analogue scale,VAS)评分及美国膝关节协会(American Knee Society,AKS)综合评分系统中的膝评分和功能评分等,评价MCSO纠正关节外的内翻畸形的效果。结果本组患者随访6～40个月,无感染、骨折、假体松动、截骨不愈合等并发症发生。本组患者手术前后的m LDFA分别为117.4°±4.7°、91.6°±1.4°;手术前后的HKA角分别为167.2°±9.8°、179.6°±1.6°;手术前后的VAS评分分别为(6.4±1.1)分、(1.8±1.5)分;手术前后的AKS膝评分分别为(60.2±17.6)分、(92.6±9.4)分;手术前后的AKS功能评分分别为(69.4±21.3)分、(87.6±14.9)分。手术前后以上指标的差异均有统计学意义(均P<0.05)。结论在合并关节外畸形的内翻膝的关节置换手术中,采用MCSO技术可以正确纠正内翻力线,更容易实现伸屈间隙平衡,达到满意的手术疗效。能有效避免对膝关节后内侧和内侧组织结构的过度松解,从而避免单纯依赖软组织松解而导致的屈曲位内侧间隙松弛及髌股关节对位不良等问题。

引用

页码：308 / 312

页数：5

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