胫骨高位截骨术失败后行全膝关节假体置换术的长期疗效观察

目的 针对胫骨高位截骨术(high tibial osteotomy,HTO)失败后行全膝人工关节置换术(total knee arthmplasty,TKA)进行长期疗效观察,分析其远期临床疗效及术中注意事项.方法 选择法国Medico-Chirurgical du Cedre中心1990年3月-1992年6月18例(19膝)HTO术后失败的患者并行TKA治疗.所有关节均有内外侧间室退变,4例伴有外侧胫骨平台中度骨缺损.采用X线测量和膝关节协会评分系统(Knee Society Scoring System,KSS)评估手术疗效,X线测量包括髋膝踝角(hip knee ankle,HKA)、α角、β角、髌骨指数、胫骨平台后倾角等.结果 TKA中11膝因HTO术后严重外翻和髌骨外侧半脱位而在TKA中行胫骨结节截骨及内移术;5膝因侧方软组织条件差或平衡不良而置入半限制型假体.随访时18例患者中2例死亡,获访16例(17膝).无失访和翻修病例.7膝在随访时出现严重聚乙烯衬垫磨损,但临床症状较轻.随访时KSS平均147.2分,优良率82%. 结论 HTO术后行TKA临床疗效优良.但由于外翻畸形和髌股关节并发症多见,可能需采用胫骨结节截骨术并内移术;HTO术后外翻畸形为TKA软组织平衡和胫骨截骨造成一定困难,术前应准备置入限制性更高的假体.     

全膝关节置换术治疗创伤性关节炎的相关问题

创伤性关节炎(PTOA)是指关节及周围组织创伤后, 引起关节软骨破坏、变性, 软骨下骨、滑膜、关节囊及周围肌肉韧带损伤, 导致骨关节炎和关节功能障碍。膝关节PTOA主要表现为膝关节疼痛、僵硬及运动能力下降, 其治疗包括物理治疗、药物干预和手术。药物和物理疗法只能暂时缓解疼痛, 长期预后欠佳。对于中晚期患者首选手术治疗, 手术包括关节镜下清理术、软骨修复术、截骨术、关节融合术, 终末期患者必须行全膝关节置换术(TKA)。由于既往手术史、软组织条件差、力线异常、关节合并症多、个体差异大等原因, TKA治疗难度增加, 尤其是目前TKA治疗仍缺乏相关的规范和标准。为此, 笔者就膝关节PTOA患者行TKA治疗的相关问题进行探讨, 为临床管理提供参考。     

膝关节置换矫正外翻畸形时个性化截骨与统一6°外翻截骨的中期疗效比较

目的探讨膝关节置换矫正外翻畸形时个性化截骨与统一6°外翻截骨中期疗效。方法将2008年1月至2014年1月在我科行膝关节置换矫正外翻畸形患者32例,随机分为观察组和对照组,各16例。观察组患者给予个性化截骨膝关节置换术;对照组给予统一6°外翻截骨膝关节置换术。根据X线片比较术前和术后膝外翻角度,应用HSS膝关节评分系统进行中期疗效评价。结果术后随访6个月,两组患者切口均一期愈合,无感染、无腓总神经麻痹发生。两组患者术后膝外翻角度、膝关节HSS评分、膝关节活动度较手术前明显好转,差异具有统计学意义(P<0.05)。观察组患者平均手术时间、下床活动时间、术后平均引流量明显低于对照组患者,差异有统计学意义(P<0.01)。结论个性化截骨技术保证每位患者都有适合自己的截骨模具,从而达到理想的手术效果。     

CT结合双下肢负重位力线X线影像制作3D打印个性化模具辅助行膝关节置换术临床研究

目的探讨膝关节CT结合双下肢负重位力线X线影像制作3D打印个性化模具在全膝关节置换术(TKA)精确截骨中的应用价值。方法选取自2014年4月至2016年6月沈阳军区总医院骨科收治的须行TKA患者32例,随机分为3D打印TKA组(20膝)和常规TKA组(19膝)各16例。3D打印TKA组应用膝关节CT结合双下肢负重位力线X线影像制作3D打印个性化模具辅助行TKA;对照组应用常规截骨器械行TKA。记录两组患者完成股骨及胫骨截骨所用的时间、所得胫骨侧截骨片厚度与术前规划之间的偏差以及两组患者的手术时间。结果 3D打印TKA组股骨及胫骨截骨的完成时间为(27.8±4.3)min,常规TKA组为(36.5±6.2)min,两组比较,差异有统计学意义(t=31.752,P<0.05)。3D打印TKA组胫骨侧截骨厚度与术前规划厚度偏差为(1.60±0.67)mm,常规TKA组为(3.40±1.35)mm,两组比较,差异有统计学意义(t=23.247,P<0.05);3D打印TKA组手术时间为(57.0±7.3)min,常规TKA组为(58.0±8.0)min,两组比较,差异无统计学意义(t=0.961,P>0.05)。两组患者均未出现并发症。结论应用膝关节CT结合双下肢负重位力线X线影像制作3D打印个性化模具辅助行TKA能缩短股骨及胫骨截骨所需时间,使胫骨侧截骨更加精确,但对整个TKA所需时间无明显改善。     

内侧撑开胫骨高位截骨术中骨性合页与胫骨轴向旋转改变的三维CT模型研究

目的:探讨内侧撑开胫骨高位截骨矫正膝内翻术后胫骨轴向旋转改变的影响因素。方法:利用CT扫描数据建立胫腓骨近端的三维几何模型,在此模型基础上通过几何操作,模拟以内侧撑开方式进行胫骨高位截骨矫正膝关节内翻,分析截骨矫正过程中合页轴的方向及内翻矫正程度与术后胫骨轴向旋转之间的关系。结果:以矢状位前后方向作为参考,与此相比,当合页轴的方向指向前外侧时会导致术后胫骨内旋增大;同时,需要矫正的内翻角度越大,术后胫骨内旋增加越多。结论:内侧撑开胫骨高位截骨术后胫骨轴向旋转的变化与截骨矫正过程中合页轴的方向及内翻矫正程度密切相关。     

三维CT重建应用于个体化全膝关节置换术的研究

目的探讨三维CT重建在个体化全膝关节置换术中应用的临床效果,研究两者的有机结合点,为进行标准化个体化全膝关节置换术提供依据。方法对2011年3月~2014年5月入组的72例中重度膝骨性关节炎病例行双下肢全长CT扫描并三维建模,获取关键角度和截骨数据,制定个体化截骨方案,获得最佳下肢力线和截骨参数,将术前所得数据付诸手术操作中,分别于术前和术后第2周获取下肢力线角与标准角度的偏差度数和美国特种外科医院膝关节评分(HSS)数据,计算优良率。结果术后患者的下肢力线接近理想力线,术前下肢力线角与标准角偏差度数为8.1482°±1.5957°,术后下肢力线角与标准角偏差度数为1.0627°±0.6401°,术前术后偏差度数采用配对资料t检验(t=13.6683,P=0.039),具有统计学意义;膝关节HSS评分较高,由术前的(49.6±6.1)分提高到术后2周的(88.2±4.1)分,术后与术前相比,有统计学意义(P=0.041);根据术后HSS评分进行评价,优58例,良10例,中3例,差1例,优良率为94.44%。结论术前三维重建膝关节,测量重要参数并制定术前规划,能够减少手术误差,提高手术精度,有助于正确重建下肢力线、准确定位截骨和植入假体,为实现全膝关节置换术的个体化和标准化提供临床依据。     

股骨后髁角与股骨假体旋转对线在人工全膝关节置换术中的应用

全膝关节置换术(total knee arthroplasty,TKA)中,股骨假体对线决定了髌骨轨迹及膝关节屈膝间隙的稳定性[3].若股骨假体安放不当会导致髌骨与股骨假体的过度磨损,从而使假体寿命缩短或出现一系列髌骨并发症及膝前痛等症状.股骨外科上髁轴(surgical epicondylar axis,SEA)是膝关节屈伸旋转轴线.传统的根据股骨后髁轴(posterior condylar line,PCL)外旋3°截骨安放股骨假体的方案缺乏个性化,有学者建议在TKA之前行CT检查测量股骨后髁角(posterior condylar angle,PCA),从而使TKA术中股骨假体的旋转对线尽量与SEA平行,从而达到最好的力学重建效果[3].笔者通过测量TKA术后患者股骨假体PCA及髌骨适合角(congruence angle,CA)和外侧髌股角(lateral patellofemoral angle,LPTA),旨在分析术后假体PCA与CA及LPTA间的相关关系,以及不同手术方式对患者术后CA及LPTA的影响.     

全膝关节置换术后获得性低位髌骨的研究进展

获得性低位髌骨指继发于创伤或全膝关节置换术(total knee arthroplasty,TKA)等形成的以髌骨远离股骨滑车或髌韧带缩短为特点,是TKA术后髌骨不稳的表现之一.可能与术中髌骨外翻,不恰当的截骨,外侧松解,髌下脂肪垫的完全切除和髌腱短缩等相关[1-4].其中,由于膝关节线抬高而髌骨相对股骨处于正常位置所引起的髌骨位置异常称假性低位髌骨[1,2];由于髌韧带与胫骨上端之间瘢痕形成或髌韧带缩短而导致的髌骨位置异常称为真性低位髌骨[5]. 获得性低位髌骨的发生使得股膝关节结构改变,导致膝关节活动范围减小、伸肌滞后、膝前痛和假体磨损等[1 -3,6,7],从而影响TKA的疗效和增加患者的痛苦.近年来,国内外关于TKA术后获得性低位髌骨的研究有所报道,但未进行系统的分析和整理.因此,笔者回顾近期关于TKA术后获得性低位髌骨的诊断、病因、治疗及其与膝关节功能之间关系的相关研究进展.     

膝关节置换术中膝内翻角度与胫骨近端内外侧截骨厚度差值的相关性探讨

目的在膝关节置换术中,胫骨截骨多采取髓外定位。由于术者经验及手术切口较小及铺单较厚等原因,胫骨定位杆的放置容易受到影响,导致胫骨近端截骨不准确,最终造成膝畸形纠正不足。本研究通过在术前计算测量病人下肢力线得出膝内翻角度,在膝关节置换术中靠胫骨近端内侧平台与外侧平台截骨厚度差值,来矫正膝内翻恢复下肢力线,为术中胫骨截骨提供数字化的依据。方法:通过收集本院自2015年至今的膝关节置换患者62例,根据膝内翻角度分为<10°、10-14°、15-20°、>20°四组,术前常规摄下肢全长X线正位片,从股骨头中心至股骨髁中心连线,胫骨近端中心与距骨中心连线,两线夹角为膝内翻角度。根据膝内翻角度,计算胫骨近端内外侧截骨的厚度差,为手术中胫骨截骨提供依据,并与术后拍片测量检验截骨效果结果通过术前术后数据收集、统计及分析,总结4组内翻角度的截骨差值,根据差值作为术前的胫骨截骨指导,与术中测量有少许偏差,但对于手术力线有明显的指导作用。结论在基层医院,由于没有导航系统帮助,只能根据膝内翻角度,计算胫骨近端内外侧截骨的厚度差。在手术当中以这个高度差为基准截骨,可以确保胫骨近端截骨的准确性,从而保证了胫骨假体的垂直力线安装,无内外翻畸形恢复了下肢力线保证了手术效果。     

OWHTO与TKA治疗膝关节内翻畸形的疗效对比

目的探讨内侧开放楔形胫骨高位截骨术(OWHTO)与人工全膝关节置换术(TKA)治疗膝关节内翻畸形的临床效果。方法分析2018年3月-2019年4月收治并完成术后6个月随访的84例膝关节内翻畸形患者的临床资料,依据采取术式不同分为两组,对照组(TKA治疗,42例)和观察组(OWHTO治疗,42例),观察分析两组的临床指标、疼痛程度、膝关节活动程度和功能改善情况。结果观察组手术时间及切口长度均较对照组短,术中出血量均较对照组少,差异有统计学意义(t=7.735、7.751、8.214,P=0.000);术后3 d,观察组和对照组的视觉模拟评分法(VAS)评分分别为(2.21±0.62)分、(2.74±0.61)分,观察组VAS评分较对照组低,差异有统计学意义(t=3.949,P=0.001);术后6个月,观察组的膝关节活动度(ROM)及美国HSS膝关节评分系统评分均较对照组高,差异有统计学意义(t=4.973、2.700,P=0.000、0.008)。结论采用OWHTO与TKA治疗膝关节内翻畸形患者,均可获取一定效果,但OWHTO的治疗效果更为显著,可有效促进患者病情恢复,改善膝功能,利于预后。     

快速成型技术在颌面头颈外科中的应用

快速成型技术(rapid prototyping,RP)是指在计算机的控制下,利用三维重建数据,短时间内通过材料的堆积制作出物体原型的一种数字化成型技术。近年来在国内外医学多个领域开始应用并迅速发展,但在我国尚未推广,临床应用还存在诸多问题。本文主要从快速成型技术的原理、模型制作过程以及在颌面头颈外科领域中的应用和前景方面作一评述。     

快速康复理念在骨肉瘤人工膝关节置换术围术期中应用

目的探讨快速康复理念在骨肉瘤人工膝关节置换术围术期实施方法及效果观察。方法选取中国医科大学附属第四医院骨外科自2013年10月至2017年1月收治的15例采用人工膝关节置换术治疗的骨肉瘤患者设为快速康复组,围术期采用快速康复理念管理;18例采用人工膝关节置换术治疗的骨肉瘤患者设为常规组,实施常规治疗。比较两组的术后康复情况。结果快速康复组患者术后下床活动时间明显早于常规组,并发症明显少于常规组,术后膝关节活动度的优良率明显高于常规组,随访3个月时的膝关节功能评分明显高于常规组,两组间比较,差异均有统计学意义(P<0.05)。结论对骨肉瘤人工膝关节置换术的患者围术期实施快速康复管理,能够促进术后康复。     

计算机辅助个体化导航模板在Hangman骨折中的临床应用

目的 利用计算机辅助个体化导航模板为Hangman骨折后路经椎弓根固定提供准确定位. 方法 Hangman骨折患者CT连续扫描,三维重建软件MIMICS 10.01建立Hangman骨折三维模型,以STL格式导出模型.在UG lmageware 12.0平台打开三维重建模型.利用逆向工程(RE)原理寻找椎弓根的最佳进钉钉道.提取椎板的表面解剖学形态,建立与椎板解剖学形态一致的模板.拟合模板和椎弓根孔道成定位模板,将椎体和定位模板通过激光快速成形技术生产出实物模板,手术时利用建立的定位模板与椎体的后部结构相吻合,通过导航孔进行C2椎弓根的定位,置入椎弓根螺钉.同法制作C3椎弓根钉导航模板,对需行C2,3后路固定时进行C3椎弓根钉的导航定位.术后根据X线片和CT扫描评价椎弓根螺钉的位置.结果 应用于4例患者,2例行C2,3椎弓根同定融合,2例行单纯C2椎弓根螺钉固定;共置入C2椎弓根螺钉8枚,C3椎弓根螺钉4枚.术中模板与暴露的椎板贴合紧密,稳定性好,所有椎弓根螺钉置入均顺利.所有患者术中和术后末出现血管和神经并发症. 结论利用逆向工程原理和快速成形技术生产出的导航模板具有较好的准确性,为Hangman骨折椎弓根的定位提供了一种新的方法,利用该方法可使Hangman骨折后路固定手术简单及安全化.     

Quadriceps femoris muscle voluntary isometric force production and relaxation characteristics before and 6 months after unilateral total knee arthroplasty in women

The purpose of the present prospective intervention study was to evaluate voluntary isometric force production, relaxation and activation capacity of the quadriceps femoris (QF) muscle before and 6 months after unilateral total knee arthroplasty (TKA). TKA was performed in ten women with primary knee osteoarthritis (OA) using the condular endoprostheses. Isometric maximal voluntary contraction (MVC) force, rate of force development at 50% of MVC (RFD₅₀) and their ratio to body mass, half-relaxation time (HRT) and voluntary activation (VA) of the QF muscle were recorded in patients for operated and non-operated leg before and 6 months after TKA. Established characteristics were compared with data on the dominant leg of ten age- and gender-matched controls. The clinical examination was performed using the Knee Society System (KSS) scores and pain intensity was assessed by visual analogue scale. MVC force in operated leg was lower (P < 0.05) before and 6 months after TKA as compared with the non-operated leg (31 and 32%, respectively) and controls (48 and 44%, respectively). Patients had lower (P < 0.05) VA of the QF muscle in operated leg 6 months after TKA as compared to controls. Significant increase (P < 0.05) of KSS clinical scores and the tendency for the increasing of explosive force production of QF muscle in the operated leg were observed 6 months after TKA (RFD₅₀ was 60% lower before TKA and 40% lower 6 months after surgery as compared to controls). When compared with the preoperative value, HRT prolongation (P < 0.05) was noted 6 months after TKA in QF muscle of both legs in patients. Therefore, the present study confirmed that patients with knee OA had reduced force generation ability of QF muscle before TKA and the improvement of explosive force was noted 6 months after surgery.     

三维模型技术在颅面创伤修复中的应用

目的 利用电子束CT扫描、三维重建和快速成型技术制作三维头颅模型，探讨其在治疗严重颅颌面骨折、缺损中的意义。方法 26例严重颅颌面创伤患者，电子束CT连续薄层容积扫描，CT数据传至工作站后行三维重建并转换成STL文件格式。将处理后的数据输入AFS-320QZ激光快速成型机制造三维头颅模型。在此模型上直接进行测量、设计、手术模拟和个性化骨缺损修复体的预制，并制定相应的治疗计划。结果 根据CT数据制作的三维模型能立体、精确地显示颅面三维解剖结构及其相互关系，再现畸形或病体原型，为准确了解和掌握病情并制定合理的手术治疗计划提供了极为重要的依据，提高了手术治疗效果。结论 CT扫描数据基础上制作的三维模型是现代颅颌面创伤修复的新型诊断和手术模拟方法，具有重要的临床实用价值。     

全膝关节置换术的隐性失血及影响因素分析

目的 研究全膝关节置换术(total knee arthroplasty,TKA)后隐性失血的特点及影响因素,为临床工作提供参考依据. 方法对75例因膝关节骨性关节炎行初次单侧TKA患者(男21例,女54例;平均年龄68.7岁)进行回顾性分析;应用Gross方程推算隐性失血量.分析性别、术中是否松止血带止血、是否应用自体引流血回输等因素对TKA术后隐性失血量的影响. 结果 本组围术期总失血量(1 551.3±369.6)ml,隐性失血量(792.3±228.6)ml.男性患者的隐性失血量高于女性(P＜0.05);术中松止血带止血能减少隐性失血量(P＜0.05);应用自体引流血回输对隐性失血量无显著影响. 结论取术后红细胞压积(Hct)的最低值(行异体输血的患者选输血后的最低值)作为参数计算隐性失血量更具有代表性.男女患者之间的相对隐性失血量差异无统计学意义;术中松止血带止血可减少隐性失血量,但对围术期总失血量不产生影响.术后自体引流血回输并不影响围术期总失血量和隐性失血量,但可降低异体血输血率.     

TKA outcomes after prior bone and soft tissue knee surgery

Purpose

Bone surgery around the knee joint could represent a more traumatic prior surgical procedure compared to soft tissue knee surgery and may predispose to differing postoperative total knee arthroplasty (TKA) outcomes. The objective of this study was to analyse the postoperative results as well as complications and failures in two groups of patients that had undergone knee surgery prior to primary TKA (bone surgery and soft tissue surgery) when compared to the no prior surgery group.

Methods

A retrospective and cohort series of 1,474 primary TKA were evaluated at minimum follow-up period of 2 years: 1,119 primary TKA underwent no prior surgery (1,119 patients) (group A), 85 primary TKA (85 patients) (group B) had prior bone procedure [high tibial osteotomy (n = 64), tibial plateau fracture (n = 10) and patellar realignment (n = 11)], and third group of 146 primary TKA (146 patients) (group C) had undergone a soft tissue procedure [arthroscopy (n = 60) and menisectomy (n = 86)] before primary TKA. All the patients underwent a clinical and radiological evaluation as well as International Knee Society (IKS) scores.

Results

Preoperatively, group B had 40 % of cases classified as stage IV knee arthritis (p < 0.02); while 57 % of cases in group A showed higher levels of knee malalignment (p = 0.001) and group C had lower BMI (p = 0.001). Intraoperative complications revealed no difference. Although group B had the poorest postoperative mean values of knee flexion, TKA procedure improved the preoperative mean values of knee flexion in all the study groups. The postoperative complications were more prevalent in group C (p < 0.001), while the percentage of revision TKA was similar for all study groups (p = 0.5). At 120-month follow-up, the Kaplan–Meier survival curve rates showed no difference (p = 0.29).

Conclusion

This study confirms that prior knee surgery could be considered a clinical condition predisposed to higher postoperative complication rate in primary TKA compared to the no prior surgery group. After analysing the three study groups, group C showed a higher rate of postoperative local complications and lower IKS knee scores, while the group B showed the poorest postoperative mean values of knee flexion as well as the need for extended surgical approach (TTO approach) was more prevalent in this study group. However, statistical analysis did not reveal a direct correlation between the type of prior knee surgery and TKA failures.

Level of evidence

IV.     

Intraoperative evaluation of total knee replacement: kinematic assessment with a navigation system

Interest in the kinematics of reconstructed knees has increased since it was shown that the alteration of knee motion could lead to abnormal wear and damage to soft tissues. We performed intraoperative kinematic measurements using a navigation system to study knee kinematics before and after posterior substituting rotating platform total knee arthroplasty (TKA). We verified intraoperatively (1) if varus/valgus (VV) laxity and anterior/posterior (AP) laxity were restored after TKA; (2) if TKA induced abnormal femoral rollback; and (3) how tibial axial rotation was influenced by TKA throughout the range of flexion. We found that TKA improved alignment in preoperative osteoarthritic varus knees which became neutral after surgery and maintained a neutral alignment in neutral knees. The VV stability at 0° was restored while AP laxity at 90° significantly increased after TKA. Following TKA, the femur had an abnormal anterior translation up to 60° of flexion, followed by a small rollback of 12 ± 5 mm. TKA influenced the tibia rotation pattern during flexion, but not the total amount of internal/external rotation throughout whole range of flexion, which was preserved after TKA (6° ± 5°). This study showed that the protocol proposed might be useful to adjust knee stability at time zero and that knee kinematic outcome during total knee replacement can be monitored by a navigation system.     

Is previous knee arthroscopy related to worse results in primary total knee arthroplasty?

According to literature, knee arthroscopy is a minimal invasive surgery performed for minor surgical trauma, reduced morbidity and shortens the hospitalization period. Therefore, this type of surgery before total knee arthroplasty (TKA) could be considered a minor procedure with minimum postoperative complication. A retrospective and cohort series of 1,474 primary TKA was performed with re-assessment after a minimum follow-up period of 2 years: 1,119 primary TKA had no previous surgery (group A) and 60 primary TKA had arthroscopic debridement (group B). All the patients underwent a clinical and radiological evaluation as well as IKS scores. Statistical analysis of postoperative complications revealed that group B had a higher postoperative complication rate (P < 0.01). In this group, 30% of local complications were re-operated and 8.3% of these cases underwent revision TKA (P < 0.01). The mean interval between arthroscopy and primary TKA was 53 months. However, statistical analysis did not reveal a direct correlation between arthroscopy/primary TKA interval and postoperative complications/failures (P = 0.55). The Kaplan–Meier survival curves showed a survival rate of 98.1 and 86.8% at 10 years follow-up for groups A and B, respectively. Our data allow us to conclude that previous knee arthroscopy should be considered a factor related to postoperative primary TKA outcomes as demonstrated by the higher rate of postoperative complications and failures (P < 0.001) as well as a worse survival curve than group A.     

人工全膝关节置换术治疗严重畸形膝关节临床研究

目的：探讨人工全膝关节置换术（total knee arthroplasty, TKA）治疗严重畸形膝关节的手术方法和临床疗效。方法对人工全膝关节置换术916例（1031膝）,严重畸形膝关节置换术80例,其中56例（70膝）成功随访。严重内翻畸形19例（23膝）、严重外翻畸形21例（27膝）、严重屈曲畸形16例（20膝）。术后平均随访时间60个月（6个月～10年）。对膝关节屈伸活动度、HSS、KSS膝关节评分系统对手术前后进行回顾性研究。结果膝关节屈伸活动度由术前平均80°（伸直0°～屈曲120°）提高到术后115°（伸直0°～屈曲130°）,膝关节评分系统 HSS、KSS术前及随访时比较差异有统计学意义（P＜0．05）,KSS评分：临床评分由术前平均33分（10～68分）提高到术后平均81分（70～100分）,HSS临床评分由术前平均43分（27～68分）提高到术后平均86分（72～100分）。膝内外翻、屈曲挛缩畸形得到较好矫正。结论严重畸形膝关节通过关节置换术同样能恢复正常的关节功能,提高了患者生活质量,获得满意的临床疗效。