中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (11): 1026–1030.doi: 10.12007/j.issn.0258-4646.2016.11.016

• 论著 • 上一篇    下一篇

生物型与标准型膝关节表面置换术近期临床疗效的随机对照研究

于忠申 1,白希壮 2,王岩峰 1   

  1. 1 中国医科大学附属第一医院运动医学关节外科,沈阳 110001;2 辽宁省人民医院骨科,沈阳 110016
  • 收稿日期:2016-01-22 出版日期:2016-11-29 发布日期:2016-11-04
  • 通讯作者: 白希壮 E-mail:bai_xizhuang@163.com
  • 作者简介:于忠申(1989 -),男,医师,硕士研究生 .

Comparison of Outcomes between Cementless and Cemented Total Knee Arthroplasty:a Randomized,Prospective Study

YU Zhongshen1,BAI Xizhuang2,WANG Yanfeng1   

  1. 1 Department of Sports Medicine and Joint Surgery,The First Hospital,China Medical University,Shenyang 110001,China;2 Department of Orthopaedics,The People’s Hospital of Liaoning Province,Shenyang 110016,China
  • Received:2016-01-22 Online:2016-11-29 Published:2016-11-04

摘要: 目的 比较钽金属(TM)生物型膝关节与标准型膝关节假体的近期临床疗效。方法 选取 2010 年 1 月到 2015 年 5 月行 单膝关节表面置换术的 150 例患者,采用随机分组的方法将患者分为 TM 生物型膝关节组(即胫骨平台侧假体采用非骨水泥固 定)和标准型膝关节组(即胫骨平台侧假体采用骨水泥固定),其中 5 例患者未参加随访。71 例(48.9%)患者采用 TM 生物型膝 关节,74 例(51.1%)患者采用标准型膝关节。评估并比较患者术后的膝关节活动度、美国特种医院评分(HSS 评分)、影像学检 查(X 线)的差异。结果 术后 6 个月对患者进行随访,145 例(96.6%)患者得到随访。术后 HSS 评分 TM 生物型膝关节组患者平 均为 91.8 分,标准型膝关节组患者平均为 90.2 分,差异无统计学意义(P > 0.05)。术后膝关节平均活动度屈膝角度 TM 生物型膝 关节组患者为 125.3°,标准型膝关节组患者为 124.5°,差异无统计学意义(P > 0.05)。TM 生物型膝关节组 92.9%(66/71)的患者 术前感觉疼痛或严重疼痛,术后 73.2%(52/71)的患者无疼痛感觉。标准型膝关节组 94.5%(70/74)的患者术前感觉疼痛或严重 疼痛,术后 74.3%(55/74)的患者感觉无疼痛。2 组患者术后经 X 线检查均显示关节位置良好。TM 生物型膝关节组 91%的患者 术后感觉满意,标准型膝关节组 90%的患者术后感觉满意。结论 在短期临床随访研究中生物型人工膝关节表面置换与标准 型膝关节假体比较,未显示出明显的优势。

关键词: 膝关节表面置换术, 非骨水泥型膝关节假体, 骨性关节炎

Abstract: Objective To compare the clinical efficacy between trabecular metal(TM)cementless and cemented total knee arthroplasty(TKA).Methods The records of 150 cases,who were treated with TKA from January 2010 to May 2015,were collected and divided into TM cementless prosthesis group(that is,the tibia lateral platform fixed by uncemented prosthesis)and cemented prosthesis group(that is,the tibia lateral platform fixed by cemented prosthesis)according to the randomized method. There were 5 cases lost follow-up. 71(48.9%)patients were treated with TM cementless prosthesis and 74(51.1%)patients were treated with cemented prosthesis. The complications were observed after operation. Knee society scores(HSS)and radiographic results were used to assess the knee function between TM cementless prosthesis and cemented prosthesis. Results The mean follow-up was 4.5 years for a total of 145 cases(96.6%). The mean postoperative knee society scores were 91.8 in TM cementless prosthesis group and 90.2 in cemented prosthesis group,and there was no significant difference between the two groups(P > 0.05). Postoperatively,the mean knee bending angle was 125.3° in TM cementless prosthesis group compared with 124.5° in cemented prosthesis group,and no significant difference was found between the two groups(P > 0.05). Preoperatively,92.9%(66/71)of patients in TM cementless prost-hesis group feel pain or severe pain;postoperatively,73.2%(52/71)of patients didn’t feel pain. Preoperatively,94.5%(70/74)of patients feel pain in cemented prosthesis group;postoperatively,74.3% of the patients didn’t feel pain. Postoperatively,the X-ray examination showed excellent implant position in both groups,and no significant difference was observed between the two groups. Postoperatively,91% of patients feel satisfied in TM cementless prosthesis group compared with 90% in cemented prosthesis group. Conclusion There is no obvious benefit of TM cementless prosthesis compared with cemented prosthesis in short-term follow-up.

Key words: total knee arthroplasty, cementless knee prosthesis, ostioarthristis

中图分类号: 

  • R867.4
[1] 边磊,白希壮,王立国,王军,杜张珍,李旭. 重组人促红素在人工膝关节表面置换术后红细胞动员中的作用[J]. 中国医科大学学报, 2016, 45(9): 835-837.
[2] 顾世忠,梁庆威,李良满,周志成,刘晓峰. 全髋关节置换术治疗老年髋关节骨性关节炎合并股骨转子间骨折的临床疗效分析[J]. 中国医科大学学报, 2014, 43(4): 361-362.
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