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影像引导下冠状面股骨截骨不当的全膝关节置换术的临床结果

Clinical Outcome of IM-Guided Total Knee Arthroplasty with Inappropriate Femoral Resection in Coronal Plane.

作者信息

Moon Young-Wan, Han Jeong-Hoon, Lee Keun-Ho, Jang Sung Won, Seo Jai-Gon

机构信息

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Knee Surg Relat Res. 2013 Mar;25(1):19-24. doi: 10.5792/ksrr.2013.25.1.19. Epub 2013 Feb 27.

Abstract

PURPOSE

The purpose of this study was to evaluate clinical results and accuracy of femoral cutting in the coronal plane in total knee arthroplasty (TKA) using a fixed length intramedullary guide.

MATERIALS AND METHODS

From 2005 to 2008, 101 patients (154 knees) underwent TKA (NexGen LPS implant). The minimal follow-up period was 3 years (mean, 4.4 years). The patients were divided into two groups (group 1, 94≤α angle<98; group 2, 94>α, 98≤α). Mechanical axis deviation (MAD), patellar tilting angle (PTA), Knee Society Knee Score (KSKS), and Knee Society Function Score (KSFS) were measured in both groups.

RESULTS

There were 120 knees in group 1 and 34 knees in group 2. There was no significant intergroup difference in the postoperative MAD (group 1, 1.59°; group 2, 1.91°). The number of outliers with ≥2° MAD was 65 in group 1 and 24 in group 2. The mean PTA, KSKS, and KSFS were 10.17°, 96.0, and 96.6, respectively, in group 1 and 11.58°, 84.5, and 85.5, respectively, in group 2.

CONCLUSIONS

The percentage of coronal alignment outliers was relatively high (34 in 154 cases, 22%) after TKA using a fixed length intramedullary guide. However, there was no statistically significant intergroup difference in clinical results (KSKS, p=0.67; KSFS, p=0.56).

摘要

目的

本研究旨在评估使用定长髓内导向器进行全膝关节置换术(TKA)时股骨在冠状面截骨的临床效果及准确性。

材料与方法

2005年至2008年,101例患者(154膝)接受了TKA(NexGen LPS植入物)。最短随访期为3年(平均4.4年)。患者被分为两组(第1组,94°≤α角<98°;第2组,α角<94°或α角≥98°)。测量两组的机械轴偏移(MAD)、髌骨倾斜角(PTA)、膝关节协会膝关节评分(KSKS)和膝关节协会功能评分(KSFS)。

结果

第1组有120膝,第2组有34膝。术后MAD组间无显著差异(第1组,1.59°;第2组,1.91°)。MAD≥2°的异常值数量在第1组为65个,在第2组为24个。第1组的平均PTA、KSKS和KSFS分别为10.17°、96.0和96.6,第2组分别为11.58°、84.5和85.5。

结论

使用定长髓内导向器进行TKA后,冠状面力线异常的比例相对较高(154例中有34例,22%)。然而,临床结果(KSKS,p = 0.67;KSFS,p = 0.56)组间无统计学显著差异。

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