全膝关节置换术两种股骨假体定位的比较△

Comparison of two kinds of femoral component positioning in total knee arthroplasty

摘要:

[目的] 探讨应用陀螺仪股骨髓外定位截骨行全膝关节置换的可行性及临床疗效。[方法] 回顾性分析 2019 年 3 月 —2020 年 1 月行初次全膝关节置换的 53 例患者 (61 膝) 的临床资料，其中 27 例使用陀螺仪髓外定位股骨侧截骨行全膝关节置换术(髓外组)，34 例行传统髓内导向杆定位股骨侧截骨全膝关节置换术(髓内组)，比较两组临床疗效。[结果]所有患者均顺利完成手术，髓外组的手术时间、股骨截骨时间均少于髓内组 (P＜0.05)；髓外组的术中失血量、术后引流量均少于髓内组(P＜0.05)。两组患者术后 3 个月膝关节 KSS 评分差异无统计学意义(P＞0.05)。两组患者术前、术后的髋膝踝角及术前、术后股胫角差异均无统计学意义(P＞0.05)。[结论]全膝关节置换陀螺仪股骨髓外定位截骨疗效较好，能减少手术时间，降低术中失血量和术后引流量。

Abstract:

[Objective] To investigate the clinical efficacy of gyroscope extramedullary femoral positioning in total knee arthroplasty (TKA) . [Methods] A retrospective analysis was done on 53 patients who received primary TKA from March 2019 to January 2020. Of them, 27 patients had femoral component placed by using gyroscope for extramedullary positioning (the extramedullary group), while the other 34 patients underwent conventional intramedullary positioning for femoral component placement (the intramedullary group). The clini- cal efficacy was compared between the two groups. [Results] All patients got operation completed successfully. The extramedullary group proved significantly superior to the intramedullary group in terms of the operation time, femur osteotomy time, intraoperative blood loss and postoperative drainage volume (P＜0.05) . However, there was no significant difference in knee KSS scores between 2 groups 3 months after operation (P＞0.05) . Radiographically, there were no significant differences in terms of hip knee and ankle angle (HKA) and femorotibial an- gle (FTA) between the two groups preoperatively and postoperatively (P＞0.05) . [Conclusion] This gyroscope extramedullary positioning is effective technique in TKA, has advantages of reducing the operation time, intraoperative blood loss and postoperative drainage.