固定平台型及移动平台型假体全膝关节置换术后临床效果分析比较.docVIP

固定平台型及移动平台型假体全膝关节置换术后临床效果分析比较 　 作者：王晓峰，陈百成，师晨霞，高石军，邵德成，王飞，李 彤，陆博，陈竟青 【摘要】 ［目的］对应用移动平台型假体和固定平台后稳定型假体全膝关节置换术(total knee arthroplasty，TKA)后进行随访对照研究，分析这两种假体TKA术后的临床效果。［方法］ 对2003年1月～2004年12月间诊断为膝骨性关节炎的患者，随机应用固定平台后稳定型假体(scorpio)和移动平台型假体(Gemini MKⅡ )行TKA手术。记录术前及随访时术膝的膝关节评分、疼痛评分、功能评分、髌骨评分和膝关节活动度，及股骨角、胫骨角、膝外翻角、胫骨平台后倾角、髌骨高度。［结果］术前固定平台组和移动平台组的年龄、体重指数、患膝内翻畸形、最大屈曲度及屈曲挛缩度均无统计学差异(Pgt;0.05)。术后平均随访31个月，固定平台组和移动平台组的术前术后膝关节评分、疼痛评分、功能评分、髌骨评分均无统计学差异(Pgt;0.05)，都明显改善了患膝的症状和功能。固定平台组和移动平台组的术后最大屈曲度（108°±9.3°，99.5°±10.1°）间存在显著性差异(Plt;0.05)。两组的股骨角、胫骨角、膝外翻角、胫骨平台后倾角、术前术后髌骨高度无显著性差异(Pgt;0.05)。［结论］平均随访31个月时固定平台后稳定型假体和移动平台假体TKA均明显改善了患膝的症状和功能，两组的膝关节评分、功能评分、疼痛评分、髌骨评分及X线片检查评价均无显著性差异。固定平台组的术后最大屈曲度大于移动平台组的术后最大屈曲度。 【关键词】 关节成形术；置换； 膝；膝假体；固定平台；移动平台 　　Comparison of the clinical results of fixedbearing and mobilebearing total knee arthroplasty 　　Abstract：［Objective］The purpose of this prospective randomized study was to compare the postoperative recovery and early clinical results of 2 groups of patients undergoing total knee arthroplasty (TKA): one group received a fixedbearing posteriorstabilized prosthesis (scorpio) and the other group received a mobilebearing prosthesis (Gemini MKⅡ). ［Method］From January 2003 to December 2004，patients with osteoarthritis were assigned at random to receive fixedbearing TKA or mobilebearing TKA. At each followup recorded the total knee score，pain score，patient function score，patellar score and the range of motion of the knee.And anteroposterior and lateral radiographies were taken to evaluate the position of the prosthesis.［Result］There was no significant difference between the two groups for age，BMI，virus deformity，maximum knee flexion and flexion contracture preoperatively (Pgt;0.05).The patients of 2 groups were followed up averaged 31 months.These was no significant difference between the 2 groups (Pgt;0.05) at preoperatively and postoperatively the total knee score，preoperatively and postoperatively pain score，preoperatively and postoperatively patient functi