Kim Y-H, Kim J-S, Kim D-Y
The Joint Replacement Centre of Korea, Ewha Womans University, DongDaeMun Hospital, 70 ChongRo 6-Ga, ChongRo-Gu, Seoul, (110-783) Korea.
J Bone Joint Surg Br. 2007 Apr;89(4):467-70. doi: 10.1302/0301-620X.89B4.18663.
We performed a prospective, randomised study to compare the results and rates of complications of primary total knee replacement performed using a quadriceps-sparing technique or a standard arthrotomy in 120 patients who had bilateral total knee replacements carried out under the same anaesthetic. The clinical results, pain scales, surgical and hospital data, post-operative complications and radiological results were compared. No significant differences were found between the two groups with respect to the blood loss, knee score, function score, pain scale, range of movement or radiological findings. In contrast, the operating time (p = 0.0001) and the tourniquet time (p < 0.0001) were significantly longer in the quadriceps-sparing group, as was the rate of complications (p = 0.0468). We therefore recommend the use of a standard arthrotomy with the shortest possible skin incision for total knee replacement.
我们进行了一项前瞻性随机研究，比较在同一麻醉下接受双侧全膝关节置换的120例患者采用股四头肌保留技术或标准关节切开术进行初次全膝关节置换的结果及并发症发生率。比较了临床结果、疼痛量表、手术及住院数据、术后并发症及影像学结果。两组在失血、膝关节评分、功能评分、疼痛量表、活动范围或影像学表现方面未发现显著差异。相比之下，股四头肌保留组的手术时间（p = 0.0001）和止血带时间（p < 0.0001）明显更长，并发症发生率也是如此（p = 0.0468）。因此，我们建议在全膝关节置换时采用尽可能短皮肤切口的标准关节切开术。
