84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]陳冰峰,孫立春.膝骨關(guān)節(jié)炎合并股骨側(cè)弓患者全膝關(guān)節(jié)置換術(shù)后下肢機(jī)械軸對手術(shù)效果的影響[J].中醫(yī)正骨,2022,34(07):22-26.
　CHEN Bingfeng,SUN Lichun.Effects of postoperative mechanical axis of the lower limb on the outcomes of total knee arthroplasty in patients with knee osteoarthritis and lateral femoral curvature[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(07):22-26.
點(diǎn)擊復(fù)制

膝骨關(guān)節(jié)炎合并股骨側(cè)弓患者全膝關(guān)節(jié)置換術(shù)后下肢機(jī)械軸對手術(shù)效果的影響()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年07期
頁碼:
22-26
欄目:
臨床研究
出版日期:
2022-07-20

文章信息/Info

Title:
Effects of postoperative mechanical axis of the lower limb on the outcomes of total knee arthroplasty in patients with knee osteoarthritis and lateral femoral curvature
作者:
陳冰峰; 孫立春
(大慶市第五醫(yī)院,黑龍江 大慶 163714)
Author(s):
CHEN Bingfeng; SUN Lichun
The Fifth Hospital of Daqing City,Daqing 163714,Heilongjiang,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換; 膝;  股骨;  畸形;  力線;  機(jī)械軸
Keywords:
arthroplasty; replacement; knee;  femur;  malformation;  lines of force;  mechanical axis
摘要:
目的:探討膝骨關(guān)節(jié)炎合并股骨側(cè)弓患者全膝關(guān)節(jié)置換(total knee arthroplasty,TKA)術(shù)后下肢機(jī)械軸對手術(shù)效果的影響。方法:選擇2006—2010年在大慶市第五醫(yī)院接受TKA治療的74例膝骨關(guān)節(jié)炎患者(74膝)的病例資料,所有患者術(shù)前股骨側(cè)弓角均>5°,術(shù)后隨訪時(shí)間均≥60個月。術(shù)后下肢機(jī)械軸矯正至中立位者34例(中立位組),術(shù)后下肢機(jī)械軸未矯正至中立位者40例(非中立位組)。比較2組患者的髖-膝-踝(hip-knee-ankle,HKA)角、膝關(guān)節(jié)主動活動度、Feller髕骨評分、美國膝關(guān)節(jié)協(xié)會(American knee society,AKS)評分及并發(fā)癥發(fā)生情況。結(jié)果:①HKA角。術(shù)后即刻和末次隨訪時(shí),中立位組的HKA角均大于非中立位組(178.9°±1.1°,176.1°±1.0°,t=2.779,P=0.008; 178.1°±1.0°,171.9°±1.3°,t=20.395,P=0.000); 中立位組術(shù)后即刻與末次隨訪時(shí)的HKA角比較,差異無統(tǒng)計(jì)學(xué)意義(t=3.919,P=0.752); 非中立位組末次隨訪時(shí)的HKA角較術(shù)后即刻時(shí)減小(t=2.845,P=0.019)。②膝關(guān)節(jié)主動活動度。術(shù)前及末次隨訪時(shí),2組患者的膝關(guān)節(jié)主動活動度比較,組間差異均無統(tǒng)計(jì)學(xué)意義(105.2°±10.3°,104.7°±10.1°,t=0.208,P=0.836; 121.6°±10.7°,120.8°±10.5°,t=0.714,P=0.477); 與術(shù)前相比,末次隨訪時(shí)2組患者的膝關(guān)節(jié)主動活動度均增大(t=-5.303,P=0.000; t=-6.713,P=0.000)。③Feller髕骨評分。術(shù)前及末次隨訪時(shí),2組患者的Feller髕骨評分比較,組間差異均無統(tǒng)計(jì)學(xué)意義[(17.3±2.2)分,(16.4±2.1)分,t=1.806,P=0.075;(26.2±1.7)分,(25.7±2.1)分,t=0.899,P=0.371]; 與術(shù)前相比,末次隨訪時(shí)2組患者的Feller髕骨評分均增大(t=-21.008,P=0.000; t=-21.562,P=0.000)。④AKS評分。術(shù)前及末次隨訪時(shí),2組患者的AKS評分比較,組間差異均無統(tǒng)計(jì)學(xué)意義[(60.4±6.5)分,(58.3±7.8)分,t=1.213,P=0.229;(92.7±5.0)分,(90.4±7.3)分,t=1.548,P=0.126]; 與術(shù)前相比,末次隨訪時(shí)2組患者的AKS評分均增大(t=-133.158,P=0.000; t=-18.217,P=0.000)。⑤并發(fā)癥發(fā)生情況。2組各有1例患者發(fā)生股骨假體周圍骨折,均接受手術(shù)治療,術(shù)后骨折均愈合良好; 非中立位組2例發(fā)生聚乙烯襯墊磨損,最終接受翻修手術(shù)。結(jié)論:膝骨關(guān)節(jié)炎合并股骨側(cè)弓患者TKA術(shù)后下肢機(jī)械軸未矯正至中立位,對膝關(guān)節(jié)功能恢復(fù)無明顯影響,但可能導(dǎo)致術(shù)后下肢矯正機(jī)械軸丟失加快、假體磨損加劇。
Abstract:
Objective:To explore the effects of postoperative mechanical axis of the lower limb(MAL)on the outcomes of total knee arthroplasty(TKA)in patients with knee osteoarthritis(KOA)and lateral femoral curvature.Methods:The medical records of 74 patients(74 knees)who received TKA for KOA in The Fifth Hospital of Daqing City from 2006 to 2010 with the preoperative lateral femoral curvature angle >5 degrees and the postoperative follow-up time≥60 months were selected.After TKA,the MAL was corrected to neutral position in 34 patients(neutral position group),and wasn't in 40 cases(non-neutral position group).The hip-knee-ankle(HKA)angle,active range of motion(ROM)of knee,Feller's patella score,American knee society(AKS)score and postoperative complication incidence were compared between the 2 groups.Results:①The HKA angles were greater in neutral position group compared to non-neutral position group immediately after the TKA and at the last follow-up(178.9±1.1 vs 176.1±1.0 degrees,t=2.779,P=0.008; 178.1±1.0 vs 171.9±1.3 degrees,t=20.395,P=0.000).There was no statistical difference in HKA angles between immediately after the TKA and at the last follow-up in neutral position group(t=3.919,P=0.752),while the HKA angles decreased in non-neutral position group at the last follow-up compared to immediately after the TKA(t=2.845,P=0.019).②There was no statistical difference in the active ROM of knees between the 2 groups before the TKA and at the last follow-up(105.2±10.3 vs 104.7±10.1 degrees,t=0.208,P=0.836; 121.6±10.7 vs 120.8±10.5 degrees,t=0.714,P=0.477).The active ROM of knees increased in the 2 groups at the last follow-up compared to pre-TKA(t=-5.303,P=0.000; t=-6.713,P=0.000).③There was no statistical difference in Feller's patella scores between the 2 groups before the TKA and at the last follow-up(17.3±2.2 vs 16.4±2.1 points,t=1.806,P=0.075; 26.2±1.7 vs 25.7±2.1 points,t=0.899,P=0.371).The Feller's patella scores increased in the 2 groups at the last follow-up compared to pre-TKA(t=-21.008,P=0.000; t=-21.562,P=0.000).④There was no statistical difference in AKS scores between the 2 groups before the TKA and at the last follow-up(60.4±6.5 vs 58.3±7.8 points,t=1.213,P=0.229; 92.7±5.0 vs 90.4±7.3 points,t=1.548,P=0.126).The AKS scores increased in the 2 groups at the last follow-up compared to pre-TKA(t=-133.158,P=0.000; t=-18.217,P=0.000).⑤The periprosthetic femur fracture was found in 1 patient in each group,and the fractures healed well after surgical treatment.Moreover,the wear of polyethylene inserts was found in 2 patients in non-neutral position group,and a revision TKA was performed respectively in the end.Conclusion:An unsuccessful correction of MAL has no significant impact on the recovery of knee function after TKA,while it may accelerate the loss of correction of MAL and aggravate the wear of prosthesis after TKA in patients with KOA and lateral femoral curvature.

參考文獻(xiàn)/References:

[1] 潘盛,鄭欣,黃超然.全膝關(guān)節(jié)置換術(shù)下肢力線的研究進(jìn)展[J].中國骨與關(guān)節(jié)損傷雜志,2020,35(8):894-896.
[2] 吳博.股骨解剖形態(tài)對膝關(guān)節(jié)置換術(shù)中股骨假體冠狀位對線的影響[D].重慶:第三軍醫(yī)大學(xué),2017.
[3] 王波,胡海濤,潘健,等.膝關(guān)節(jié)骨性關(guān)節(jié)炎全膝關(guān)節(jié)置換術(shù)后下肢力線與早期臨床效果關(guān)系的研究[J].中國骨與關(guān)節(jié)損傷雜志,2015,30(10):1044-1048.
[4] 李超,程靜波,馮明利.從生物力學(xué)角度認(rèn)識股骨解剖結(jié)構(gòu)對膝關(guān)節(jié)置換的影響[J].中國組織工程研究,2020,24(36):5850-5857.
[5] 郭新宇,王直兵,張峽,等.外弓股骨膝內(nèi)翻患者固有內(nèi)翻力線的術(shù)前計(jì)劃[J].中華醫(yī)學(xué)雜志,2020,100(15):1175-1179.
[6] 周頤,向柄彥.全膝關(guān)節(jié)置換術(shù)脛骨假體旋轉(zhuǎn)定位研究進(jìn)展[J].中國矯形外科雜志,2021,29(12):1110-1114.
[7] FELLER J A,BARTLETT R J,LANG D M.Patellar resurfacing versus retention in total knee arthroplasty[J].J Bone Joint Surg Br,1996,78(2):226-228.
[8] MARTIMBIANCO A L,CALABRESE F R,IHA L A,et al.Reliability of the“American Knee Society Score”(AKSS)[J].Acta Ortop Bras,2012,20(1):34-38.
[9] 卿明松,彭笳宸,楊禮丹,等.關(guān)節(jié)置換治療膝骨關(guān)節(jié)炎合并股骨側(cè)弓:傳統(tǒng)方法及計(jì)算機(jī)導(dǎo)航輔助的對比[J].中國組織工程研究,2019,23(32):5203-5208.
[10] 馬崇文,李睿,閻亮,等.計(jì)算機(jī)導(dǎo)航技術(shù)在全膝關(guān)節(jié)置換術(shù)中的應(yīng)用進(jìn)展[J].中國醫(yī)學(xué)物理學(xué)雜志,2019,36(3):369-372.
[11] 于清波,鄂正康,辛紅偉,等.計(jì)算機(jī)導(dǎo)航下全膝關(guān)節(jié)置換術(shù)對術(shù)中出血量及關(guān)節(jié)功能恢復(fù)的影響[J].中國骨傷,2020,33(1):15-20.
[12] 邢川明,徐燕,王黎明.導(dǎo)航技術(shù)與傳統(tǒng)膝關(guān)節(jié)置換后下肢力線的Meta分析[J].成都醫(yī)學(xué)院學(xué)報(bào),2018,13(5):594-599.
[13] 張波,江敞,朱云森,等.計(jì)算機(jī)導(dǎo)航系統(tǒng)輔助全膝關(guān)節(jié)置換術(shù)治療膝關(guān)節(jié)骨性關(guān)節(jié)炎的早期療效[J].臨床骨科雜志,2021,24(6):792-797.
[14] 袁偉,趙輝,符培亮,等.三維打印個體化器械在全膝關(guān)節(jié)置換術(shù)中的應(yīng)用[J].中華關(guān)節(jié)外科雜志(電子版),2016,10(2):71-73.
[15] 方亮,董睿,金紅婷,等.3D打印個體化器械操作在全膝關(guān)節(jié)置換術(shù)中的應(yīng)用現(xiàn)狀[J].中國骨傷,2019,32(6):582-586.
[16] FANG D M,RITTER M A,DAVIS K E.Coronal alignment in total knee arthroplasty:just how important is it?[J].J Arthroplasty,2009,24(6 Suppl):39-43.
[17] BELLEMANS J,COLYN W,VANDENNEUCKER H,et al.The Chitranjan Ranawat Award:is neutral mechanical alignment normal for all patients?The concept of constitutional varus[J].Clin Orthop Relat Res,2012,470(1):45-53.
[18] 鐘昌恒,彭昊.下肢力線在全膝關(guān)節(jié)置換術(shù)的應(yīng)用進(jìn)展[J].生物醫(yī)學(xué)工程與臨床,2022,26(2):253-257.
[19] 喻長純,王戰(zhàn)朝,尚延春.膝關(guān)節(jié)內(nèi)翻屈曲畸形全膝關(guān)節(jié)置換的軟組織平衡[J].中國修復(fù)重建外科雜志,2007,21(10):1062-1066.
[20] MATZIOLIS G,ADAM J,PERKA C.Varus malalignment has no influence on clinical outcome in midterm follow-up after total knee replacement[J].Arch Orthop Trauma Surg,2010,130(12):1487-1491.

相似文獻(xiàn)/References:

[1]邢金明.切開復(fù)位鎖定鋼板內(nèi)固定術(shù)和人工半肩關(guān)節(jié)置換術(shù) 治療老年肱骨近端復(fù)雜骨折的對比研究[J].中醫(yī)正骨,2015,27(08):11.
　XING Jinming.A retrospective trial of open reduction and locking plate internal fixation versus artificial shoulder hemiarthroplasty for complicated proximal humeral fractures in old patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):11.
[2]趙云昌.人工股骨頭置換治療老年粉碎性股骨轉(zhuǎn)子間骨折[J].中醫(yī)正骨,2015,27(08):31.
[3]張明強(qiáng).生物型加長柄半髖關(guān)節(jié)置換術(shù)治療 高齡不穩(wěn)定股骨轉(zhuǎn)子間骨折療效觀察[J].中醫(yī)正骨,2015,27(02):56.
[4]蔡云仙.圍手術(shù)期耳穴按壓聯(lián)合平衡針療法 在全膝關(guān)節(jié)置換術(shù)后鎮(zhèn)痛中的應(yīng)用[J].中醫(yī)正骨,2015,27(06):41.
[5]喻長純,楊明路,王戰(zhàn)朝.不同手術(shù)方式治療脛骨平臺骨折畸形愈合的體會[J].中醫(yī)正骨,2015,27(03):37.
[6]魏瑄,宋樹春,王金良.術(shù)前精確測量和評估在全髖關(guān)節(jié)置換治療 成人發(fā)育性髖關(guān)節(jié)發(fā)育不良繼發(fā)骨關(guān)節(jié)炎中的價(jià)值[J].中醫(yī)正骨,2015,27(01):30.
[7]鮑榮華,陳曉東,王國平,等.Wagner Cone生物型假體置換結(jié)合經(jīng)股骨轉(zhuǎn)子下橫形截骨 治療CroweⅣ型成人發(fā)育性髖關(guān)節(jié)發(fā)育不良[J].中醫(yī)正骨,2015,27(01):33.
[8]喻長純,楊明路,王戰(zhàn)朝.同期髕骨脫位矯正術(shù)聯(lián)合全膝關(guān)節(jié)置換術(shù)治療 晚期膝骨關(guān)節(jié)炎合并習(xí)慣性髕骨脫位[J].中醫(yī)正骨,2015,27(01):41.
[9]武理國,沈軍,傅國海,等.人工肱骨頭置換治療老年肱骨近端復(fù)雜骨折[J].中醫(yī)正骨,2013,25(10):70.
[10]李國梁,韓廣普,閆國強(qiáng),等.紅花化瘀湯薰蒸聯(lián)合理筋手法 在膝骨關(guān)節(jié)炎全膝關(guān)節(jié)置換術(shù)后康復(fù)中的應(yīng)用[J].中醫(yī)正骨,2013,25(12):31.
　Li Guoliang*,Han Guangpu,Yan Guoqiang,et al.Clinical application of HONGHUAHUAYU decoctions steaming combined with sinew adjusting manipulation in the postoperative rehabilitation of total knee arthroplasty in patients with knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(07):31.
[11]樊慶陽,任凱晶.定制3D打印切模輔助全膝關(guān)節(jié)置換術(shù)治療 膝骨關(guān)節(jié)炎合并股骨干骨折畸形愈合[J].中醫(yī)正骨,2015,27(11):37.
[12]李翰林,童培建.利福平聯(lián)合用藥配合保留假體清創(chuàng)治療 人工關(guān)節(jié)置換術(shù)后早期感染及低毒性感染[J].中醫(yī)正骨,2015,27(09):56.
[13]劉曉雅,孫永強(qiáng),劉國杰.主動快速康復(fù)鍛煉對全膝關(guān)節(jié)置換術(shù)后關(guān)節(jié)活動度的影響[J].中醫(yī)正骨,2015,27(09):73.
[14]張維平,康兩期,陳衛(wèi),等.全髖關(guān)節(jié)置換術(shù)圍手術(shù)期隱性失血的研究進(jìn)展[J].中醫(yī)正骨,2015,27(08):61.
[15]宋兵華,孫俊英,倪增良,等.全膝關(guān)節(jié)置換術(shù)前CT測量股骨后髁角的臨床意義[J].中醫(yī)正骨,2015,27(07):38.
[16]王金良,孫京濤,李玲,等.骨水泥聯(lián)合螺釘修復(fù)全膝關(guān)節(jié)置換術(shù)中 脛骨平臺內(nèi)側(cè)骨缺損[J].中醫(yī)正骨,2015,27(12):55.
[17]徐偉鋒,葉健,吳連國.強(qiáng)骨飲對骨質(zhì)疏松性股骨頸骨折患者全髖關(guān)節(jié)置換術(shù)后 血清骨代謝生化指標(biāo)和骨密度的影響[J].中醫(yī)正骨,2015,27(02):12.
　XU Weifeng,YE Jian,WU Lianguo.Effect of Qianggu Yin(強(qiáng)骨飲,QGY)on serum bone metabolism indexes and bone density after total hip arthroplasty in patients with osteoporotic femoral neck fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(07):12.
[18]張榮,王健.人工全膝關(guān)節(jié)置換術(shù)的圍手術(shù)期心理護(hù)理[J].中醫(yī)正骨,2015,27(05):77.
[19]齊志遠(yuǎn),陳秀民,王在斌,等.桃紅四物加黃芪湯預(yù)防人工髖膝關(guān)節(jié)置換術(shù)后 下肢深靜脈血栓形成[J].中醫(yī)正骨,2015,27(03):71.
[20]陸吳超,季衛(wèi)鋒,馬鎮(zhèn)川.關(guān)節(jié)鏡下清創(chuàng)后持續(xù)灌洗聯(lián)合中藥口服治療 全膝關(guān)節(jié)置換術(shù)后急性期感染[J].中醫(yī)正骨,2015,27(01):51.

備注/Memo

備注/Memo:
通訊作者:陳冰峰 E-mail:[email protected]
更新日期/Last Update: 1900-01-01