术前不同程度下肢力线内翻畸形对单髁置换术后短期疗效的影响分析
山西医科大学第二医院骨科
Influence of Different Degrees Preoperative Lower Limb Alignment Varus Deformity on the Short-term Efficacy after Unicompartmental Knee Arthroplasty
Department of Orthopaedics,the Second Hospital of Shanxi Medical University
摘要 目的 探究患者术前存在的不同程度下肢力线内翻畸形对单髁置换术后短期临床疗效的影响。方法 选择从2018年3月至2019年9月行膝关节单髁置换术的患者99例(131膝),男性29例(37膝),女性70例(94膝);年龄50~84岁,平均(64.79±7.71)岁;身体质量指数(body mass index,BMI)16.81~35.38 kg/m2 ,平均(26.17±4.04)kg/m2 。根据患者术前髋膝踝角(hip-knee-ankle angle,HKA)大小将患者分成3组,0°<HKA≤5°为轻度内翻组(A组),5°<HKA≤10°为中度内翻组(B组),10°<HKA≤15°为重度内翻组(C组)。比较三组患者性别、年龄、BMI、手术侧别、术后HKA、术前及术后的牛津膝关节评分(Oxford knee score,OKS)、疼痛视觉模拟评分(visual analogue score,VAS)、膝关节活动度(range of movement,ROM)结果,并将观察指标与术前HKA进行相关性分析。结果 所有患者均获得随访,随访时间12~30个月,平均(19.01±3.80)个月。患者术后的OKS评分、VAS评分、膝关节ROM、下肢力线内翻畸形与术前相比,差异有统计学意义(P<0.05)。术前三组患者OKS评分、VAS评分、膝关节ROM相比差异有统计学意义(P<0.05)。术后三组患者HKA大小A组为(2.80±1.82)°,B组为(3.16±1.47)°,C组为(4.79±1.84)°。术后三组患者HKA相比,差异有统计学意义(P<0.05)。三组患者末次随访时的OKS评分、VAS评分及膝关节ROM之间比较,差异无统计学意义(P>0.05)。术前HKA与术后HKA、术前OKS评分和术前膝关节ROM呈显著性相关(P<0.05)。结论 术前不同程度的内翻畸形与患者术前膝关节功能及术后下肢力线有显著相关性,但在≤15°的范围内,术前不同程度的内翻畸形并不影响单髁置换术后的短期临床疗效。
关键词 :
单髁置换术 ,
膝关节 ,
下肢力线 ,
膝内翻
Abstract :Objective To explore the effect of preoperative lower limb alignment in different degrees varus deformity after unicompartmental knee arthroplasty.Methods A total of 99 patients (131 knees) who underwent unicompartmental knee arthroplasty were selected from March 2018 to September 2019,including 29 males (37 knees) and 70 females (94 knees).The average age was (64.79±7.71).The average body mass index (BMI) was (26.17±4.04)kg/m2 .Patients were divided into three groups according to preoperative HKA(hip-knee-ankle angle),0°<HKA≤5°for mild varus (Group A),5°<HKA≤10° for moderate varus (Group B),and 10°<HKA≤15° for severe varus (Group C).The postoperative HKA,preoperative and postoperative Oxford knee score (OKS),pain visual analogue scale (VAS) and range of motion (ROM) of knee joint results of the three groups were compared,and the correlation between the observation indexes and preoperative HKA were analyzed.Results All patients were followed up for 12~30 months,an average of (19.01±3.80) months.There were statistically significant differences in OKS,VAS,ROM,the lower limb alignment varus deformity between preoperation and last follow-up(P<0.05).There were statistically significant differences in preoperative OKS,VAS and ROM(P<0.05).The postoperative HKA was(2.80±1.82)°in group A,(3.16±1.47)° in group B and (4.79±1.84)°in group C.There was statistically significant difference of postoperative HKA among three groups (P<0.05).There were no statistically significant differences in postoperative OKS,VAS and ROM at the last follow-up among the three groups (P>0.05).Preoperative HKA was significantly correlated with postoperative HKA,preoperative OKS and preoperative ROM (P<0.05).Conclusion Different degrees of preoperative lower limb alignment varus deformity has a significant correlation with the preoperative knee function and postoperative lower limb alignment,different varus deformity preoperatively do not affect the short-term clinical efficacy after unicompartmental knee arthroplasty (range of 0°~15°).
Key words :
unicompartmental knee arthroplasty
knee
lower limb alignment
genu varum
通讯作者:
张民
作者简介 : 李亚坤(1995- ),男,研究生在读,山西医科大学第二医院骨科,030001。
引用本文:
李亚坤,李浩,王浩浩,席刚,张民 *. 术前不同程度下肢力线内翻畸形对单髁置换术后短期疗效的影响分析[J]. 实用骨科杂志, 2020, 26(12): 1064-1069.
Li Yakun,Li Hao,Wang Haohao,et al. Influence of Different Degrees Preoperative Lower Limb Alignment Varus Deformity on the Short-term Efficacy after Unicompartmental Knee Arthroplasty. sygkzz, 2020, 26(12): 1064-1069.
链接本文:
http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2020/V26/I12/1064
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