铰链膝假体在重度外翻膝全膝关节置换术中的应用

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摘要目的探讨Endo-Model铰链膝假体在重度外翻膝人工全膝关节置换术中的可行性、安全性和有效性。方法 2010年1月至2017年1月收治10例重度外翻畸形膝关节患者，采用铰链膝关节进行人工全膝关节置换术，其中男性3例，女性7例；年龄29~72岁，平均45岁。8例为单侧，2例类风湿患者为双侧膝关节置换术。术前及术后进行胫股角(femorotibial angle，FTA)、膝关节功能评分(knee society score，KSS)和膝关节活动度进行比较，评价功能恢复情况。结果术后1、3、6、12、24、36个月门诊随访，术后疼痛明显减轻，膝关节畸形矫正，稳定性及功能均良好，伸直均达到180°，主动屈曲可达95°～125°，平均110°。KSS膝关节评分由术前34.25分，提高到术后86.73分，下肢畸形及关节功能明显改善。术后X线片显示下肢力线良好，FTA平均6.62°，假体位置良好，承载假体可靠。结论 Endo-Model旋转铰链膝关节假体置换治疗膝关节重度外翻畸形效果满意，患者膝关节功能均有显著提高，但仍需严格掌握手术适应证及远期随访。

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关键词 ：铰链膝假体, 重度外翻畸形, 人工全膝关节置换术

Abstract：Objective To investigate the feasibility，safety and efficacy of Endo-model hinged knee prosthesis in total knee arthroplasty for patients with severe valgus knee.Methods The study included 10 cases aged 29~72 years，with anaverage of 45 years old.There were 7 females and 3 males.8 cases were unilateral and 2 patients with rheumatoid arthritis were bilateral.All the patients underwent total knee arthroplasty with hinge knee joint prosthesis.Femur-tibia angle(FTA)，knee society score(KSS)，range of motion was applied to evaluate the situation of functional recovery.Results The patients were followedup at 1，3，6，12，24，36 month after surgery.The postoperative pain was significantly decreased.The knee deformity，stability and function all was good.Extension angle all reached 180°.Angle of greatest flexion can reach 95°~125°，with anaver age of 110°.KSS was improved from 34.25 before operation to 86.73 points after operation.Lower limb deformity and joint function improved.Postoperative X-ray shows good alignment and an average FTA of 6.62°.The prosthesis was on the good place.Conclusion The therapeutic effect of Endo-model rotational hinge knee prosthesis used to severe valgus knee is satisfactory.The function of knee joint was significantly improved after operation.However，the indications need to be strictly confined and long-term follow-up is still required.

Key words： hinge-knee prosthesis severe valgus deformity total knee arthroplasty

基金资助:陕西省科技厅项目(2016YFJH2-12)

通讯作者: 秦四清

作者简介: 王亚康(1985－ )，男，主治医师，西安交通大学医学部附属红会医院关节病院髋关节病区，710054。

引用本文:

王亚康，郭建斌，王涛，刘瑞，马涛，张育民，秦四清 *. 铰链膝假体在重度外翻膝全膝关节置换术中的应用[J]. 实用骨科杂志, 2018, 24(8): 701-705.
Wang Yakang，Guo Jianbin，Wang Tao，et al. Application of Hinged Knee Prosthesis in Total Knee Arthroplasty for Patients with Severe Valgus Knee. sygkzz, 2018, 24(8): 701-705.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2018/V24/I8/701

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