旋转平台与固定平台假体全膝人工关节置换术的早期疗效比较

目的比较全膝人工关节置换术应用强生旋转平台与固定平台两种假体术后早期临床疗效。 方法回顾性收集2017年1月至2018年01月济宁医学院附属医院收治的79例86侧膝关节骨性关节炎患者进行回顾性研究，其中43例46膝应用强生旋转平台，其中男性18例（18膝，39.13%），女性25例（28膝，60.87%）；左侧25膝（54.35%），右膝21膝（45.65%），年龄为55~77岁，平均（68±8）岁。36例（40膝）应用强生固定平台，其中男性16例（17膝，42.50%），女性20例（23膝，57.50%）；左侧22膝（55.00%），右膝18膝（45.00%）。年龄为54~80岁，平均（67±8）岁。所有患者均由同一位医师行固定平台假体或旋转平台假体初次TKA术。分别于手术前后评估膝关节HSS评分、膝关节活动度。 结果固定平台组或旋转平台组患者的术前活动度与末次随访活动度相比，差异均具有统计学意义（t=26.801，t=21.470，P<0.05）；固定平台组或旋转平台组患者的术前HSS评分与末次随访HSS评分相比，差异均具有统计学意义（t=35.180，t=35.053，P<0.05）。固定平台组与旋转平台组患者比较，术前及末次随访活动度差异均无统计学意义（均P>0.05），固定平台组与旋转平台组患者比较，术前及末次随访HSS评分差异均无统计学意义（均P>0.05）。 结论旋转平台假体与固定平台假体TKA术后早期临床总体疗效相似。两种假体均能明显改善膝关节活动度及膝关节功能。无论使用哪种假体，短期随访时间内都不会影响到效果。

Comparison of early clinical outcomes between rotating platform and fixed platform prosthesis in total knee arthroplasty: a short-term result

ObjectiveTo compare the early postoperative clinical outcomes of rotating platform and fixed platform prosthesis in total knee arthroplasty. MethodsA retrospective study was performed on 79 patients (86 cases) with diagnosis of knee osteoarthritis from January 2017 to January 2018, including 43 patients with 46 knees using a rotating platform, thereinto 18 males with 18 knees (39.13%), 25 females with 28 knees (60.87%). 25 left knee (54.35%), 21 right knee (45.65%), age range was 55 to 77 years old, and the average was (68±8) years old. 36 patients (40 knee) using a fixed platform, including 16 males with 17 knees (42.50%), 20 females with 23 knees (57.50%), 22 left knee (55.00%), 18 right knee (45.00%), age range was 54 to 80 years old and the average was (67±8) years old. All patients underwent primary TKA with a fixed platform prosthesis or a rotating platform prosthesis. The knee joint HSS score and range of motion of knee were evaluated before and after surgery. ResultsThe preoperative range of motion of knee in the fixed platform group or the rotating platform group was statistically different with the last follow-up range of motion of knee (t=26.801, t=21.470, P<0.05).The preoperative HSS scores of the patients in the fixed platform group or the rotating platform group were statistically different compared with the last follow-up HSS score (t=35.180, t=35.053, P<0.05). There was no significant difference in range of motion of knee between the fixed platform group and the rotating platform group at preoperative and the last follow-up. There was no significant difference in the HSS between the fixed platform group and the rotating platform group at preoperative and the last follow-up. ConclusionsThe overall clinical efficacy of the rotating platform prosthesis and the fixed platform prosthesis in total knee arthroplasty was similar. Both prostheses significantly improved mobility and function of knee compared to preoperative. No matter which type of prosthesis was used, it will not affect the clinical effect during short-term follow-up.