人工全膝表面关节置换治疗骨性膝关节炎47例

目的　分析总结人工全膝表面关节置换治疗骨性膝关节炎的临床效果及经验。方法　对 4 7例 5 3膝的骨性膝关节炎病例行人工膝关节置换术 ,单膝关节置换 4 1例 ,双膝关节置换 6例 1 2膝。应用后方稳定型假体 2 1例 2 5个膝关节 ,保留后交叉韧带型假体 2 6例 2 8个膝关节。结果　 39例 4 5个膝关节获 1年以上随访 ,采用HSS评分标准 ,膝关节评分从术前 35分提高到术后 89分 ,术后 4 0个膝关节活动度≥ 90°,4 2 / 4 5膝关节术后膝关节力线正常 ,3例残留 5°～ 7°内翻。结论　人工全膝表面关节置换治疗骨性膝关节炎可取得良好效果。术中精确的截骨操作与正确的软组织松解获得的软组织平衡是手术治疗成功的关键。

Report of 47 Patients with Knee Orthrodesis Treated by Total Condylar Knee Replacemeut

Objective To analyse and summarize the clinical effect of knee orthrodesis treated by total condylar knee replacement.Methods There were 47 patients,total 53 knees with orthrodsis treated by total condylar knee replacement from September 1996 to May,2003.Forty one cases were treated by single total condylar knee replacement,6 cases were treated by bilateral total condylar knee replacement.Twenty five knees were treated by posterior stabilize prosthesis,28 knees were treated by prosthesis of preserved posteror cruciate ligament.Results Thirty nine patient with 45 knees were followe up more than one year,We used Hss mark to evaluate the function of knee.The marks increased from 35 marks before operation to 89 marks after operation.Degree of motion of 40 cases were more than 90 degree after operation.The line of knee of about 42/45 of knee joint were normal.Three cases retarred 5 to 7 degree genu varum.Conclusion The satisfactory effect maybe achieved using total condglar knee replacement to treat knee orthrodesis.The keys of operation are the accurately osteotomy and properly release of soft tissue.