后方稳定型全膝人工关节置换术疗效随访分析

目的探讨后方稳定型全膝人工关节置换术(PSKA)治疗膝关节疾患的临床应用价值. 方法 1995年7月～2000年7月 ,共计PSKA (Insall-Burstein II)18例(19膝),男2 例(3膝),女16例(16膝),其中双侧 1例.年龄44～78岁,平均62.5岁.术前诊断膝关节骨性关节炎15膝,类风湿关节炎 4膝,伴有骨质缺损4膝.术前X线测量膝内翻畸形16膝,膝外翻畸形3膝,屈曲畸形8膝,, 有膝关节手术史2膝.17(18膝)例随访41～60个月,平均49个月.根据HSS膝关节百分评分系统进行评估. 结果术前平均62分,术后平均89分 ,活动范围(ROM)术前平均91°,术后平均115°,其中优11膝,良5膝,中1膝,差 1膝,手术优良率88.9%. 结论 PSKA可增加膝关节R OM和最大屈曲度,并限制其向后半脱位.它不但用于原发的膝关节疾病,还应用于膝关节翻修术的患者.髌骨并发症在PSKA最常见,应给予重视.

Posterior stabilized knee arthroplasty: 5-year follow up

Objective To evaluate the middle-term results of posterior stabilized knee arthroplasty(PSKA). Methods From July 1995 to July 2000, 19 knees of 18 patients were replaced with posterior stabilized prosthesis (Insall-Burstein II). Among the patients, 2 were male, and 16 female. Their average age was 62.5 years (44-78 years). One patient was operated on bilaterally. Preoperative diagnosis revealed osteoarthritis in 16 knees, and rheumatoid arthritis in 3 knees. Four knees demonstrated severe bone deficiency during surgery. Before operation, 15 of the rest knees were varusly deformed, 4 were valgusly deformed, and 8 had flexion contracture. Two patients underwent surgery previously. 17 patients (18 knees) were follow-uped for 41-60 months, each of them was evaluated with the Special Surgery Knee Scoring System. Results Average preoperative scores increcsed from 62 preoperation to 89 postoperatively. The range of motion was significantly improved from 91 degrees preoperatively to 115 degrees postoperatively. Eleven knees were rated as excellent,5 good,1 fair, and 1 poor. The excellent and good rate was 88.9%. Conclusions With its design features, PSKA can effectively improve the range of motion and maximum flexion angle without compromising posterior stability. PSKA is suitable for both primary and revision total knee arthoplasty but caution should be taken for patellar complications.