旋转铰链型人工膝关节假体的临床应用

目的：探讨旋转铰链型人工膝关节临床应用的近期疗效。方法：2003年2月～2012年4月，应用旋转铰链型人工膝关节假体进行全膝关节置换术治疗膝关节严重畸形和不稳定23例膝。其中骨性关节炎15例，类风湿性关节炎6例，左股骨骨折术后创伤性关节炎l例，左胫骨平台骨折术后创伤性关节炎合并前交叉韧带、内侧半月板损伤及内侧侧副韧带断裂l例。术前HSS（hospital for special surgery）评分36～58分，平均48．6分；术前膝关节屈曲活动度21°～80°，平均57.4°。结果：术后患者均获随访6个月～3年，平均23．6个月。无下肢静脉血栓形成、无腓总神经麻痹等并发症发生。23例患者随访时，HSS评分78～98分，平均91．1分，较术前平均增加45．5分，且差异有统计学意义（P〈0．05）；术后2周，膝关节屈曲活动度为75°～100°，平均85．2°，最后随访时膝关节屈曲活动度为85°～120°，平均108．3°，与术前比较差异有统计学意义（P〈0．05）。结论：旋转铰链型人工膝关节置换术近期疗效肯定，远期疗效尚待进一步随访。

Clinical Application of Rotation Hinge Knee Prosthesis

Objective ：To study the short - term effect of the rotating hinge clinical application of artificial knee. Methods：From July 2003 to April 2012, the rotating hinge -type artificial knee prosthesis was used to treat 23 cases of total knee arthroplasty for severe knee joint deformity and instability of the knee. Among which,15 cases of osteoarthritis, rheumatoid arthritis, 6 cases of rheumatoid arthritis, 1 case of left femur fracture after traumatic arthritis, the left tibial plateau fracture traumatic arthritis after being combined anterior cruciate ligament, medial meniscus and within the lateral collateral ligament rupture in 1 case. The preoperative HSS （hospital for special surgery） score ranged from 36 to 58 points, an average of 48.6 points; preoperative knee flexion ranged from 21 to 80 degrees, with an average of 57.4 degrees. Results：The patients were followed up for 6 months to 3 years, an average of 23.6 months. There were no peroneal nerve paralysis, fracture or extensor mechanism rupture and other complications. Last follow - up of 23 cases, the HSS score from 78 to 98, with an average of 91.1 points compared with the preoperative average of 45.5 points, and the difference was statistically significant （ P 〈 0. 05 ）. 2 weeks after surgery, knee flexion ranged from 75 to 100 degrees, with an average of 85.2 degrees, the last follow -up knee flexion ranged from 85 to 120 degrees, with an average of 108.3 degrees, and the difference between the preoperative had statistically significance （ P 〈 0.05 ）. Conclusions：The short- term effect of rotating hinge total knee arthroplasty is affirmative; the long- term efficacy remains to be further follow - up.