Ⅱ型外翻膝的非限制性关节置换：后稳定型还是保留交叉韧带型？
Unconstrained arthroplasty in type II valgus knees: posterior stabilized or cruciate retaining?
机构信息
Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Level 4, Singapore, 169856, Singapore,
出版信息
Knee Surg Sports Traumatol Arthrosc. 2014 Mar;22(3):666-73. doi: 10.1007/s00167-013-2677-7. Epub 2013 Sep 22.
PURPOSE
Type II valgus knees are defined by medial collateral ligament laxity. This paper studies the results of posterior stabilized (PS) and cruciate retaining (CR) knee implants in type II valgus knees.
METHODS
From 1999 to 2009, there were 100 type II valgus knees in 95 patients eligible for study (63 PS, 37 CR). Patients had prospectively collected clinical data up to 2 years after surgery.
RESULTS
At 24 months after surgery, the CR group had reduced range of motion (PS: median 126.0°, CR: median 114°; n.s.) and a marginally but statistically significant increased valgus alignment (PS: median 5°, CR: median 6°; p = 0.011). Despite this, both groups produced equal and marked improvements in SF-36, function score and knee score of the Knee Society score, and Oxford knee score.
CONCLUSIONS
Overall, both PS and CR implants performed equally well in type II valgus knees at 24 months post-operatively. Further longer-term studies would be warranted to assess for late instability.
LEVEL OF EVIDENCE
Retrospective, Level III.
目的
II 型外翻膝由内侧副韧带松弛引起。本文研究了后稳定型（PS）和前交叉韧带保留型（CR）膝关节植入物在 II 型外翻膝中的治疗效果。
方法
1999 年至 2009 年，95 名患者中的 100 例 II 型外翻膝符合研究条件（63 例 PS，37 例 CR）。患者前瞻性地收集了术后 2 年的临床数据。
结果
术后 24 个月时，CR 组的活动范围减小（PS：中位数 126.0°，CR：中位数 114°；无统计学意义），且外翻角度有轻微但具有统计学意义的增加（PS：中位数 5°，CR：中位数 6°；p=0.011）。尽管如此，两组的 SF-36、功能评分、膝关节学会评分和牛津膝关节评分的膝关节评分都有明显的改善。
结论
总体而言，PS 和 CR 植入物在术后 24 个月时在 II 型外翻膝中表现相当。需要进一步进行更长期的研究来评估晚期的不稳定性。
证据等级
回顾性，III 级。
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