Zhou Kun-peng, Zhang Xue-bing, Zhang Guo-dong, Yang Guang, Qi Xin
Zhongguo Gu Shang. 2015 Oct;28(10):897-902.
To compare the early clinical outcomes of primary total knee arthroplasty in the valgus knee between mobile-bearing prosthesis and fixed-bearing prosthesis.
From January 2011 to December 2013, 17 patients (23 knees) treated by the same surgeon were selected for a retrospective study in the First Hospital of Jilin University, including 2 males and 15 females with a mean age of 61.5 years old (48 to 75 years). The pre-operative diagnosis included osteoarthritis (14 patients, 19 knees) and rheumatoid arthritis (3 patients, 4 knees). The patients with valgus deformity were divided into group A and group B. The patients in group A were treated with the fixed-bearing prosthesis (9 patients, 12 knees), and the patients in group B were treated with the mobile-bearing prosthesis (8 patients, 11 knees). The Knee Society Score (KSS), Hosptial for Special Surgery (HSS), Western Ontario MacMaster (WOMAC), the range of motion (ROM) and femorotibial angle were collected at pre-operation and post-operation follow-up for statistical analysis.
All the patients were followed up, and the duration ranged from 6 to 36 months (mean 25 months). The valgus deformity was corrected in all patients, and there were significant differences for all patients between pre-operation and post-operation at the latest follow-up with regard to the KSS knee score, function score, HSS score, WOMAC score, ROM and femorotibial angle (P<0.01). There were no significant differences in KSS knee score, function score, HSS score, WOMAC score, improvement in ROM and femorotibial angle between two groups at the latest follow-up. However there were significant differences in ROM (P<0.05) between fixed-bearing group (101.8±8.8)° and mobile-bearing group (108.4±7.2)° at the latest follow-up. No case with spin-out of mobile bearing was observed. There were no complications in any patient, such as infection, common peroneal nerve injury, dislocation and instability. The X-ary imaging showed no osteolysis or implant loosening.
The early clinical outcomes of primary total knee arthroplasty by using mobile-bearing prosthesis and fixed-bearing prosthesis are satisfactory for the treatment of the valgus knee, and the short term clinical outcomes of mobile-bearing TKA and fixed-bearing TKA are similar.
比较活动平台假体与固定平台假体在膝外翻患者初次全膝关节置换术中的早期临床疗效。
选取2011年1月至2013年12月在吉林大学第一医院由同一术者治疗的17例患者（23膝）进行回顾性研究，其中男性2例，女性15例，平均年龄61.5岁（48至75岁）。术前诊断包括骨关节炎（14例患者，19膝）和类风湿关节炎（3例患者，4膝）。将膝外翻畸形患者分为A组和B组。A组患者采用固定平台假体治疗（9例患者，12膝），B组患者采用活动平台假体治疗（8例患者，11膝）。收集术前及术后随访时的膝关节协会评分（KSS）、特种外科医院（HSS）评分、西安大略和麦克马斯特大学（WOMAC）评分、活动度（ROM）及股胫角进行统计分析。
所有患者均获随访，随访时间6至36个月（平均25个月）。所有患者膝外翻畸形均得到矫正，末次随访时所有患者术前与术后在KSS膝关节评分、功能评分、HSS评分、WOMAC评分、ROM及股胫角方面差异均有统计学意义（P<0.01）。末次随访时两组间KSS膝关节评分、功能评分、HSS评分、WOMAC评分、ROM改善情况及股胫角差异均无统计学意义。然而，末次随访时固定平台组（101.8±8.8）°与活动平台组（108.4±7.2）°的ROM差异有统计学意义（P<0.05）。未观察到活动平台脱出病例。所有患者均未出现感染、腓总神经损伤、脱位及不稳定等并发症。X线影像显示无骨溶解或假体松动。
活动平台假体与固定平台假体用于膝外翻患者初次全膝关节置换术的早期临床疗效满意，活动平台全膝关节置换术与固定平台全膝关节置换术的短期临床疗效相似。
