159例Sledge单髁置换假体型号的研究

目的 对行Sledge单髁置换术人群进行临床研究,为术中准确判断假体大小,选择合适的单髁假体提供参考。 方法 回顾性分析广东省中医院骨关节科2016年2月—2017年11月开展的159例Sledge单髁置换术人群的相关临床资料。对膝关节单髁置换术(UKA)假体中股骨和胫骨的尺寸分布进行总体统计,记录该人群的基本资料,如性别、年龄、BMI指数等。根据资料分析股骨和胫骨假体之间最佳匹配关系;筛选出Sledge单髁置换人群UKA假体的影响因素,预测股骨假体型号的准确度。 结果 股骨假体型号里中号假体占21.4%,小号假体占62.8%,超小号假体占15.7%。胫骨假体型号里大号假体占19.5%,中号假体占52.8%,小号假体占27.8%。最佳匹配方案:胫骨小号匹配超小号股骨假体和小号股骨假体,胫骨大、中号匹配中号股骨假体。年龄和BMI指数这两项数据对股骨假体的判断选择无显著影响(均P>0.05),而性别及身高(女性)的影响有显著差异(均P<0.05)。建立行Sledge单髁置换人群UKA假体相关参数的分布图。对数据进行分析得出,术前辅助准确选择假体型号的因素占比情况如下:性别对术前股骨假体型号选择准确率的提高达88.1%,其中女性结合身高的准确占比达95.0%;术中再行选择判断时,胫骨假体型号的准确占比为78.6%。 结论 临床上可以通过术前身高、性别来预测Sledge单髁置换人群股骨假体型号大小。本次研究分析中所论述的Sledge UKA假体分布情况在预测判断上具备较高精度,可为术中准确判断假体大小提供有力的指导。 

Research on prosthesis size of Sledge unicondylar knee arthroplasty in 159 patients

Objective To conduct a clinical study on the population of Sledge unicondylar knee arthroplasty(UKA), and provide a reference for accurately determining the size of the prosthesis and selecting a suitable prosthesis. Methods Total 159 patients with Sledge UKA from February 2016 to November 2017 were selected and the clinical data were retrospectively analyzed. The size distribution of femur and tibia in the prosthesis of UKA was analyzed. The basic data index(sex, age, BMI) of patients were recorded. According to the data, the best matching relationship between femoral and tibial prosthesis was analyzed. The influencing factors of UKA prosthesis were screened out to predict the accuracy of femoral prosthesis. Results Among the femoral prosthesis, 21.4% are medium size prosthesis, 62.8% are small size prosthesis, and 15.7% are ultra small size prosthesis. Among the tibial prostheses, large prosthesis accounted for 19.5%, medium prosthesis for 52.8%, and small prosthesis for 27.8%. The best matching scheme was follow:small size tibia matching super small size or small size femoral prosthesis, large and medium size tibia matching medium size femoral prosthesis. The age and BMI had no significant effect on the judgment and selection of femoral prosthesis(all P>0.05), but there were significant differences in gender and height(female), all P<0.05. The distribution of the related parameters of the UKA prosthesis in Sledge population was preliminarily established. According to the analysis of data, the accuracy rate of gender to select the size of femoral prosthesis before operation is increased by 88.1%, of which the accuracy rate of women combined with height is 95.0%. The accuracy rate of tibial prosthesis size is 78.6% when selecting and judging again during operation. Conclusion The size of femoral prosthesis can be predicted by preoperative height and gender in clinic. The distribution of sledge UKA prosthesis analyzed in this study has high accuracy in prediction and judgment, which can provide powerful guidance for accurate determination of prosthesis size during operation.