膝关节屈曲内翻畸形行全膝关节置换中的软组织平衡

目的探讨膝关节屈曲内翻畸形在施行全膝关节置换中的软组织平衡技术。方法 2005年1月—2011年12月,实施18例25膝骨性关节炎(osteoarthritis,OA)人工关节表面置换,探讨术中的软组织平衡问题。结果术后随访半年~5年,平均3年,2例残留5°屈曲挛缩,1例残留内翻角>3°。术后发生并发症2例,其中内侧副韧带损伤1例,髌骨弹响1例;均无皮肤坏死、切口浅表感染及深部感染发生。结论软组织平衡在矫正膝关节屈曲内翻畸形中起重要作用,良好的软组织平衡可使屈曲内翻畸形的膝关节在关节置换术后获得明显矫正及良好的功能恢复。

Balance of soft tissues in total knee arthroplasty for patients with knee of varus deformity and flexion contracture

Objective To explore the soft tissue balancing technology in the operation of the Total Knee Arthroplasty （TKA） for the patients with the illness of varus deformity and flexion contracture. Methods From January 2005 to December 2011, reviewed the 18 patients and 25 knee cases with varus deformity and flexion contracture of their knees because of the osteoarthritis , who had been operated with the technology of TKA. At the same time, discussion of the balance of soft tissue surgery had been carried out. Results The patients had been followed up and researched for 6-60 months, with an average of 36 months, after their operation. The result shown that there were only two cases of flexion contracture with a residual 5 degrees and one case of flexion contracture with varus angle greater than 3 degrees, the others could extend their knee connections fully. There were 3 cases of postoperative complications, in which one injured in the femur starting point of the medial collateral ligaments ; one cases of the patellar clunk. The skin necrosis, incision superficial infection and deep infection were not found. Conclusion The soft tissue balance plays an important role in the correction of knee varus deformity and flexion contracture. A kind of proper soft tissue balance can ensure to obtain a obvious recovery of the correction and function of the varus deformity and flexion contracture of the knees after the TKA.