前稳定型垫片在全膝关节置换术中的早期临床研究

目的探讨全膝关节置换术(TKA)中应用前稳定型(AS)垫片的临床效果。方法 2018年1月至2018年12月选取北京大学人民医院收治的107例终末期骨性关节炎行全膝关节置换患者,术中采用邦美公司提供的后交叉韧带保留型(CR)Vanguard膝关节假体,其中使用AS垫片组45例,CR垫片组62例。统计全部患者的手术时间,术后伤口引流量,感染并发症,术前、术后膝关节活动度和膝关节协会评分,比较AS垫片组和CR垫片组之间的差异。结果全部病例均获得随访,随访时间为12~24个月,平均(20.3±2.8)个月。术前AS垫片组、CR垫片组膝关节活动度分别为平均90.2°±17.4°、92.7°±18.6°,术后末次随访时AS垫片组、CR垫片组分别为平均108.5°±22.3°、110.6°±19.3°。膝关节协会评分术前AS垫片组为临床评分(50±15)分、功能评分(52±21)分,CR垫片组为临床评分(49±13)分,功能评分(52±19)分;术后末次随访时AS垫片组临床评分(80±16)分、功能评分(82±20)分;CR垫片组临床评分(82±15)分、功能评分(83±22)分。上述各评价指标、手术时间、术后伤口引流量两组间差异均无统计学意义。所有病例均未出现感染并发症。结论 TKA术中应用AS垫片术后早期膝关节活动度、膝关节协会评分结果良好,与CR垫片相比较效果相当。

Early clinical study on the application of anterior-stabilized insert in total knee arthroplasty

Objective To investigate the clinical effect on the application of anterior-stabilized(AS) insert in total knee arthroplasty(TKA). Methods A total of 107 patients with end-stage osteoarthritis who underwent total knee arthroplasty(TKA) between January 2018 and December 2018 were selected in Peking University People Hospital . Posterior cruciate-retaining (CR) of Vanguard knee prosthesis provided by Biomet company in the operation, including 45 cases with AS insert and 62 cases with CR insert. The operation time, postoperative wound drainage volume, infection complication, preoperative and postoperative knee joint range of motion(ROM) and knee society scores(KSS) of all patients were calculated. The differences between the AS insert group and CR insert group were compared. Results All cases were followed up for 12 to 24 months,average(20.3±2.8)months. The ROM of AS insert group and CR insert group was 90.2°±17.4° and 92.7°±18.6° respectively before the operation, and that was 108.5°±22.3° and 110.6°±19.3° respectively in the last postoperative follow-up. The KSS of the AS insert group were (50±15)(clinical score) and (52±21)(functional score) before the operation, while that were (49±13) and (52±19) in the CR insert group. The KSS of AS insert group were (80±16)(clinical score) and (82±20)(functional score) at the last postoperative follow-up, while that were (82±15) and (83±22) in the CR insert group. There were no statistically differences in the above evaluation indexes, operation time and postoperative wound drainage volume between the two groups.No complications of infection occurred in all cases. Conclusion The early ROM and KSS results of AS insert used in TKA were good, which were comparable with that of CR insert.