Tanavalee Aree, Thiengwittayaporn Satit, Itiravivong Pibul
Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 2005 Sep;88 Suppl 4:S74-8.
The authors evaluated results of 136 consecutive minimally invasive total knee arthroplasties (MIS TKAs). The first 22 knees, performed with strict patient selection criteria, were determined as a learning experience. According to results of the next 114 knees, the average wound length was 9.2 centimeters and the average blood loss was 470 milliliters. At a mean follow-up of 14 months, the mean Knee Society score improved from 37.5 to 96 points with 96.3% of excellent results. Sixty-five knees, group A, had within 10 degrees of varus and 49 knees, group B, had more deformity. Clinical results of both groups were not statistically different in terms of operative time, blood loss, pain score, postoperative knee flexion at 2 weeks and 6 months and postoperative day of walking. However, the ability to straighten the knee was significantly delayed in knees with more deformity (group B). After gaining learning curve, surgeons could extend performing MIS TKA in patients with more knee deformity.
作者评估了连续136例微创全膝关节置换术（MIS TKA）的结果。前22例膝关节手术，采用严格的患者选择标准，被视为一次学习经验。根据接下来114例膝关节的结果，平均伤口长度为9.2厘米，平均失血量为470毫升。平均随访14个月时，膝关节协会平均评分从37.5分提高到96分，优良率为96.3%。65例膝关节（A组）内翻在10度以内，49例膝关节（B组）畸形更严重。两组的临床结果在手术时间、失血量、疼痛评分、术后2周和6个月时的膝关节屈曲度以及术后行走天数方面无统计学差异。然而，畸形更严重的膝关节（B组）伸直膝关节的能力明显延迟。在获得学习曲线后，外科医生可以对膝关节畸形更严重的患者开展MIS TKA手术。
