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[胫骨假体坡度对牛津单髁膝关节置换术短期临床疗效的影响]

[Influence of tibial component slope on short-term clinical outcome for Oxford unicompartmental knee arthroplasty].

作者信息

Ma L Y, Guo W S, Zhang Q D

机构信息

Department of Orthopaedic Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2017 Jun 1;55(6):430-434. doi: 10.3760/cma.j.issn.0529-5815.2017.06.006.

Abstract

To investigate the effects of tibial component slope change after microplasty (MP) Oxford unicompartmental knee arthroplasty (UKA) on short-term clinical outcome. A total of 116 patients(128 UKAs)underwent UKA in Department of Orthopaedic Surgery of China-Japan Friendship Hospital between January 2014 and December 2015 were retrospectively reviewed. Totally 100 patients (108 UKAs) were finally included in the study. There were 31 males and 69 females, aging from 47 to 90 years (mean 67.2 years). The mean height was (161.9±8.4) cm and the mean body mass index (BMI) was (26.2±3.3) kg/m(2). The posterior tibial slope (PTS) at preoperative and postoperative were measured on the lateral radiograph. The postoperative PTS were divided into five groups (<3°, 3° to 5°, 5° to 7°, 7° to 9° and>9°). The Oxford Knee Score (OKS) was recorded. Pearson correlation analysis, ANOVA and test were used to analyze data. All operations were successfully accomplished and there were no transfusion, infection, thrombus and other complications. There was 1 patient accepted revision because of bearing dislocation. Compared to preoperative, the PTS decreased (6.5°±2.2° .9.6°±3.4°) postoperative, there was statistical difference (=9.053, <0.01). Only 3 patients were beyond the recommended range (2° to 12°). A total of 82 patients (86 UKAs) were followed up. The follow-up time was 1 to 2.9 years (mean 2 years). The OKS was 43.0±4.1 (mean 31 to 48). The PTS increased in 12 patients (12 UKAs) postoperative, the mean OKS was 40.5±5.2. The PTS decreased in 70 patients (74 UKAs), the mean OKS was 43.4±3.8. There were significant difference in OKS (=2.347, =0.021). There were no significant difference in OKS between the five groups. There were positive correlation between postoperative PTS and preoperative PTS (=0.201, 95%: 0.001 to 0.396, =0.037), there were no correlations between postoperative PTS and hight and BMI. There were negative correlations between OKS and postoperative PTS (=-0.255, 95% -0.063 to -0.427, =0.018) and PTS change (=-0.292, 95% -0.08 to -0.475, <0.01). Satisfying PTS can be obtained by use of Oxford MP instrumentation. The clinical outcome of the postoperative PTS decreased was relatively better. Too large posterior slope of the tibial implant should be avoided.

摘要

探讨微塑形(MP)牛津单髁膝关节置换术(UKA)后胫骨组件倾斜度变化对短期临床疗效的影响。回顾性分析2014年1月至2015年12月在中国-日本友好医院骨科接受UKA的116例患者(128个UKA)。最终100例患者(108个UKA)纳入研究。其中男性31例,女性69例,年龄47至90岁(平均67.2岁)。平均身高(161.9±8.4)cm,平均体重指数(BMI)为(26.2±3.3)kg/m²。术前和术后在侧位X线片上测量胫骨后倾坡度(PTS)。术后PTS分为五组(<3°、3°至5°、5°至7°、7°至9°和>9°)。记录牛津膝关节评分(OKS)。采用Pearson相关分析、方差分析和检验进行数据分析。所有手术均顺利完成,无输血、感染、血栓等并发症。有1例患者因假体脱位接受翻修。与术前相比,术后PTS降低(6.5°±2.2°对9.6°±3.4°),差异有统计学意义(t = 9.053,P < 0.01)。仅3例超出推荐范围(2°至12°)。共82例患者(86个UKA)获得随访。随访时间为1至2.9年(平均2年)。OKS为43.0±4.1(平均31至48)。术后12例患者(12个UKA)PTS增加,平均OKS为40.5±5.2。70例患者(74个UKA)PTS降低,平均OKS为43.4±3.8。OKS差异有统计学意义(F = 2.347,P = 0.021)。五组之间OKS无显著差异。术后PTS与术前PTS呈正相关(r = 0.201,95%CI:0.

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