[1]任 敬,巩航辉,郑世成,等.单半径假体全膝关节置换术对重度膝关节骨性关节炎患者膝关节活动度和术后并发症的影响[J].陕西医学杂志,2022,51(10):1249-1252.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.017]
 REN Jing,GONG Hanghui,ZHENG Shicheng,et al.Effect of total knee arthroplasty with single radius prosthesis on knee range of motion and postoperative complications in patients with severe knee osteoarthritis[J].,2022,51(10):1249-1252.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.017]
点击复制

单半径假体全膝关节置换术对重度膝关节骨性关节炎患者膝关节活动度和术后并发症的影响
分享到:

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年10期
页码:
1249-1252
栏目:
临床研究
出版日期:
2022-10-05

文章信息/Info

Title:
Effect of total knee arthroplasty with single radius prosthesis on knee range of motion and postoperative complications in patients with severe knee osteoarthritis
作者:
任 敬1巩航辉2郑世成1王 敏1齐 亮1路玉峰1贾 斌1
(1.西安交通大学医学部附属红会医院中西医结合骨科,陕西 西安 710054; 2.延安大学医学院,陕西 延安 716000)
Author(s):
REN JingGONG HanghuiZHENG ShichengWANG MinQI LiangLU YufengJIA Bin
(Department of Orthopedics Combined with Traditional Chinese and Western Medicine,Honghui Hospital,School of Medicine,Xi'an Jiaotong University,Xi'an 710054,China)
关键词:
膝关节骨性关节炎 全膝关节置换术 单半径假体 膝关节功能 膝关节活动度 并发症
Keywords:
Knee osteoarthritis Total knee arthroplasty Single radius prosthesis Knee function Knee range of motion Complication
分类号:
R 684.3
DOI:
DOI:10.3969/j.issn.1000-7377.2022.10.017
文献标志码:
A
摘要:
目的:探讨单半径假体全膝关节置换术(TKA)对重度膝关节骨性关节炎(KOA)患者膝关节活动度和术后并发症的影响。方法:回顾性分析433例重度KOA患者临床资料,按照手术使用假体不同将患者分为行多半径假体TKA术的对照组(n=221例)与行单半径假体TKA术的研究组(n=212例)。观察两组术后并发症发生情况,并比较两组术前、术后3个月膝关节功能(HSS评分)、膝关节活动度(ROM)、膝关节疼痛评分(VAS)、生存质量评分(WHOQOL-100)、炎性指标[白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)]。结果:研究组术后3个月HSS评分、ROM比对照组高(均P<0.05); 研究组术前、术后3个月HSS评分、ROM差值比对照组大(均P<0.05); 研究组术后3个月VAS评分比对照组低,WHOQOL-100评分比对照组高(P<0.05); 研究组术前、术后3个月VAS评分、WHOQOL-100评分差值比对照组大(均P<0.05); 研究组术前、术后3个月IL-1β、TNF-α差值均比对照组大(P<0.05); 两组术后并发症发生率对比无统计学差异(P>0.05)。结论:相比多半径假体全膝关节置换术,重度膝关节骨性关节炎患者进行单半径假体全膝关节置换术治疗可以明显改善患者膝关节活动度,减轻膝关节疼痛,且不会增加术后并发症发生风险。
Abstract:
Objective:To investigate the effect of total knee arthroplasty(TKA)with single radius prosthesis on knee range of motion and postoperative complications in patients with severe knee osteoarthritis(KOA).Methods:The clinical data of 433 patients with severe KOA were retrospectively analyzed.Patients enrolled were divided into control group(221 cases,TKA with multi-radius prosthesis)and study group(212 cases,TKA with single-radius prosthesis)according to the prosthesis applied in TKA.Postoperative complications in the two groups were observed.Knee function(HSS score),knee range of motion(ROM),knee pain(VAS score),quality of life(WHOQOL-100 score),and inflammatory indicators [interleukin 1β(IL-1β),tumor necrosis factor-α(TNF-α)]were compared between the two groups.Results:The study group had higher HSS score and larger ROM than those in the control group at 3 months after operation(all P<0.05).The difference values of HSS score and ROM in the study group before operation and 3 months after operation were larger than those in the control group(all P<0.05).The study group had lower VAS score and higher WHOQOL-100 score than those in the control group at 3 months after operation(all P<0.05).The difference values of VAS score and WHOQOL-100 score in the study group before operation and 3 months after operation were higher than those in the control group(all P<0.05).The difference values of IL-1β and TNF-α in the study group were also higher than those in the control group(all P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Compared with TKA with multi radius prosthesis,TKA with single radius prosthesis can significantly improve knee ROM and alleviate knee pain in patients with severe KOA,without increasing the risk of postoperative complications.

参考文献/References:

[1] 吴 晔,陶忠亮,李 军,等.关节腔注射玻璃酸钠及罗哌卡因联合关节镜清理术对膝关节骨性关节炎的临床效果[J].河北医学,2019,25(9):1539-1543.
[2] 邓业川,赵敏明.温针灸,浮针及针刺治疗膝骨性关节炎临床研究[J].陕西中医,2020,41(10):1496-1499.
[3] 张若茜,杜 毅,李 淅,等.膝关节相关解剖结构测量在全膝关节置换术假体选择中的应用[J].局解手术学杂志,2020,29(6):439-443.
[4] 中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中国临床医生,2008,27(10):793-796.
[5] 张 晨,宋国瑞,刘子歌,等.低分子肝素与利伐沙班预防全膝关节置换术后静脉血栓成形的疗效及安全性对比分析[J].陕西医学杂志,2020,49(9):1153-1156.
[6] 史为鹏,王 锴,王英振,等.关节线高度变化对内轴型假体全膝关节置换术中期疗效的影响[J].中华骨科杂志,2021,41(24):1744-1752.
[7] 马登越,葛 群,王 磊,等.全膝关节置换术对膝骨关节炎患者的近期疗效[J].中国现代医学杂志,2020,30(3):102-106.
[8] 张 博,林 源,任世祥,等.后交叉韧带保留型膝关节假体置换术中部分保留与完整保留后交叉韧带的疗效比较[J].中国修复重建外科杂志,2021,35(1):51-57.
[9] 郑 斌,王文晔,谢孝枫.人工全膝关节置换术对重度膝关节骨性关节炎患者关节功能及炎性因子的影响[J].国际外科学杂志,2019,46(12):845-850.
[10] 叶碧武.重度膝关节骨性关节炎实施单半径与多半径假体全膝关节置换术治疗的效果比较[J].医药前沿,2021,11(16):92-93.
[11] 吴 鹏,郎俊哲,吴聪聪,等.胫骨冠状面弯曲导致全膝关节置换术后胫骨假体力线不良[J].中国骨伤,2022,35(1):54-58.
[12] 黄乐春,胡惠民,梁宇翔.膝关节功能评分量表评述[J].中国医药科学,2016,6(13):50-53.
[13] 孟利锋,王春成.补肾培元推拿法联合补肾活血汤治疗老年肾虚型腰椎间盘突出症的临床研究[J].陕西中医,2018,39(3):368-370.
[14] 都元涛,方积乾.世界卫生组织生存质量测定量表中文版介绍及其使用说明[J].现代康复,2000,4(8):1127-1129,1145.
[15] 范熹微,聂 涌,吴元刚,等.膝关节内侧固定平台单髁假体放置位置优化的有限元分析[J].中华骨科杂志,2020,40(3):169-177.
[16] 侯广原,张继学,张志军,等.矢状位假体位置与CR型全膝关节置换对关节活动度的影响[J].安徽医学,2020,41(1):67-69.
[17] 路 凡.多半径与单半径全膝关节假体的研究进展[J].中国矫形外科杂志,2020,28(23):2162-2165.
[18] Longo UG,Candela V,Pirato F,et al.Midflexion instability in total knee arthroplasty:A systematic review[J].Knee Surg Sports Traumatol Arthrosc,2021,29(2):370-380.
[19] Schultz BJ,Debaun MR,Huddleston JI.The use of stems for morbid obesity in total knee arthroplasty[J].J Knee Surg,2019,32(7):607-610.
[20] 江 帆,毛静妍,童雯雯,等.单半径与多半径假体全膝关节置换术治疗重度膝关节骨性关节炎的疗效比较[J].中国骨与关节损伤杂志,2020,35(4):394-396.
[21] Burchard R,Huflage H,Soost C,et al.Efficiency of platelet-rich plasma therapy in knee osteoarthritis does not depend on level of cartilage damage[J].J Orthop Surg Res,2019,14(1):153.
[22] 马颖露,廖子龙.缪刺法结合膝三针温针灸对膝关节骨性关节炎临床疗效以及IL-1β、TNF-α水平的影响[J].中医药学报,2021,49(11):73-77.

相似文献/References:

[1]杨生森,张 晨,董 毅,等.快速康复外科理论下不留置尿管对单侧人工全膝关节置换术后患者康复的影响*[J].陕西医学杂志,2020,49(12):1561.[doi:DOI:10.3969/j.issn.1000-7377.2020.12.006]
 YANG Shengsen,ZHANG Chen,DONG Yi,et al.Effect of non-indwelling urinary catheter on rehabilitation after unilateral total knee arthroplasty under the theory of ERAS[J].,2020,49(10):1561.[doi:DOI:10.3969/j.issn.1000-7377.2020.12.006]
[2]郭凤英,张 晨,李 燕,等.关节软骨Osterix蛋白表达强度对膝关节骨性关节炎形态学变化的影响[J].陕西医学杂志,2021,50(3):366.[doi:DOI:10.3969/j.issn.1000-7377.2021.03.029]
 GUO Fengying,ZHANG Chen,LI Yan,et al.Effect of the expression intensity of Osterix protein in articular cartilage on the morphological changes of knee osteoarthritis[J].,2021,50(10):366.[doi:DOI:10.3969/j.issn.1000-7377.2021.03.029]
[3]杨天翔,张晋宁,张博文,等.单髁与全膝关节置换术治疗膝单间室骨性关节炎对患者围手术期凝血指标及失血量的影响[J].陕西医学杂志,2022,51(6):684.[doi:DOI:10.3969/j.issn.1000-7377.2022.06.010]
 YANG Tianxiang,ZHANG Jinning,ZHANG Bowen,et al.Effects of UKA and TKA on perioperative coagulation indexes and blood loss in patients with knee single compartment osteoarthritis[J].,2022,51(10):684.[doi:DOI:10.3969/j.issn.1000-7377.2022.06.010]
[4]毕文超,梁立卓,刘司南.基于快速成型及3D打印技术全膝关节置换术治疗双膝骨性关节炎临床研究[J].陕西医学杂志,2022,51(6):688.[doi:DOI:10.3969/j.issn.1000-7377.2022.06.011]
 BI Wenchao,LIANG Lizhuo,LIU Sinan.Clinical study of TKA based on rapid prototyping and 3D printing in treatment of bilateral knee osteoarthritis[J].,2022,51(10):688.[doi:DOI:10.3969/j.issn.1000-7377.2022.06.011]
[5]杨天翔,张博文,张晋宁,等.术中放置引流管对初次全膝关节置换术患者围手术期失血量及术后疼痛的影响[J].陕西医学杂志,2022,51(12):1548.[doi:DOI:10.3969/j.issn.1000-7377.2022.12.019]
 YANG Tianxiang,ZHANG Bowen,ZHANG Jinning,et al.Effect of intraoperative drainage tube placement on perioperative blood loss and postoperative pain in patients with primary total knee arthroplasty[J].,2022,51(10):1548.[doi:DOI:10.3969/j.issn.1000-7377.2022.12.019]
[6]黄 玲,傅德杰,邓 姝.全膝关节置换术后深静脉血栓形成机制、危险因素及预防研究进展[J].陕西医学杂志,2024,(3):428.[doi:DOI:10.3969/j.issn.1000-7377.2024.03.031]
 HUANG Ling,FU Dejie,DENG Shu.Research progress on mechanism,risk factors and prevention of deep vein thrombosis after total knee arthroplasty[J].,2024,(10):428.[doi:DOI:10.3969/j.issn.1000-7377.2024.03.031]

备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2018SF-201)
更新日期/Last Update: 2022-10-07