高位胫骨截骨术失败后的全膝关节置换术：后交叉韧带保留型与后稳定型假体的中期比较
Total knee arthroplasty following failed high tibial osteotomy: mid-term comparison of posterior cruciate-retaining versus posterior stabilized prosthesis.
作者信息
Akasaki Yukio, Matsuda Shuichi, Miura Hiromasa, Okazaki Ken, Moro-oka Taka-aki, Mizu-uchi Hideki, Iwamoto Yukihide
机构信息
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2009 Jul;17(7):795-9. doi: 10.1007/s00167-009-0790-4. Epub 2009 Apr 9.
This study evaluated the mid-term results of total knee arthroplasty (TKA) following high tibial osteotomy (HTO), comparing posterior cruciate-retaining prostheses to posterior stabilized prostheses. The Knee Society score for the entire group (20 knees) improved significantly from 62 (median) preoperatively to 87 at the latest follow-up. The postoperative Knee Society score of 85 in posterior cruciate-retaining prostheses (8 knees) was significantly inferior to the 94 score in posterior stabilized prostheses (12 knees). Of Knee Society score, Stability and ROM scores (17 and 21, respectively) in posterior cruciate-retaining TKA were inferior to those in posterior stabilized TKA (25 and 24, respectively). Since postoperative knee instability due to posterior cruciate ligament (PCL) insufficiency is thought to contribute to the inferior results of posterior cruciate-retaining prostheses after HTO, PCL-substituting TKA would be suitable for use after HTO.
本研究评估了高位胫骨截骨术（HTO）后全膝关节置换术（TKA）的中期结果，比较了后交叉韧带保留型假体和后稳定型假体。整个研究组（20例膝关节）的膝关节协会评分从术前的中位数62分显著提高到最近一次随访时的87分。后交叉韧带保留型假体组（8例膝关节）术后膝关节协会评分为85分，显著低于后稳定型假体组（12例膝关节）的94分。在后交叉韧带保留型全膝关节置换术中，膝关节协会评分、稳定性评分和活动度评分（分别为17分和21分）低于后稳定型全膝关节置换术（分别为25分和24分）。由于后交叉韧带（PCL）功能不全导致的术后膝关节不稳定被认为是HTO后后交叉韧带保留型假体效果较差的原因，因此PCL替代型全膝关节置换术适用于HTO术后。
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