Yulou Si, Yanqin Xue, Yongjun Xing
Department of Orthopedics of Yulin Xingyuan Hospital of Shanxi, 719000, China.
Department of Cardiology of Yulin Xingyuan Hospital of Shanxi, 719000, China.
Open Med (Wars). 2015 Dec 17;10(1):457-461. doi: 10.1515/med-2015-0079. eCollection 2015.
To discuss the method and effect of total knee arthroplasty osteotomy and soft tissue release for serious knee joint space narrowing. Clinical data of 80 patients from October 2013 to December 2014 was selected with a retrospective method. All patients have undergone total knee arthroplasty. Then the X-rays plain film in weight loading was measured before and after operation and osteotomy was performed accurately according to the knee joint scores and the conditions of lower limb alignments. The average angle of tibial plateau osteotomy of postoperative patients was 4.3°, and the corrective angle of soft tissue balancing was 10.7°; the postoperative patients' indicies including range of joint motion, knee joint HSS score, angle between articular surfaces, tibial angle, femoral-tibial angle and flexion contracture were distinctly better than the preoperative indicies (p<0.05) and the differences were statistically significant; the postoperative patients' flexion contracture and range of joint motion were distinctly better than the preoperative indicies (p<0.05) and the differences were statistically significant. The effective release of the soft tissue of the posterior joint capsule under direct vision can avoid excess osteotomy and get satisfactory knee replacement space without influencing the patients' joint recovery.
探讨全膝关节置换术中截骨及软组织松解治疗严重膝关节间隙狭窄的方法及效果。采用回顾性方法选取2013年10月至2014年12月80例患者的临床资料。所有患者均接受全膝关节置换术。然后在负重位拍摄X线平片,测量手术前后情况,并根据膝关节评分及下肢力线情况精确截骨。术后患者胫骨平台截骨平均角度为4.3°,软组织平衡矫正角度为10.7°;术后患者的关节活动度、膝关节HSS评分、关节面夹角、胫骨角、股胫角及屈曲挛缩等指标明显优于术前指标(p<0.05),差异有统计学意义;术后患者的屈曲挛缩及关节活动度明显优于术前指标(p<0.05),差异有统计学意义。直视下有效松解后关节囊软组织,可避免过度截骨,获得满意的膝关节置换空间,且不影响患者关节恢复。