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[骨水泥联合螺钉修复全膝关节置换术中胫骨平台缺损的短期疗效]

[Short-term effectiveness of bone cement combined with screws for repairing tibial plateau defect in total knee arthroplasty].

作者信息

Liu Shaofeng, Wang Sen, Wu Tianhao, Fan Zhongwei, Zhang Yue, Rao Yong, Tan Meiyun

机构信息

Department of Bone and Joint Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China.

Department of Bone and Joint Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou Sichuan, 646000,

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Sep 15;31(9):1055-1058. doi: 10.7507/1002-1892.201704016.

Abstract

OBJECTIVE

To summarize the effectiveness of bone cement combined with screws for repairing tibial plateau defect in total knee arthroplasty (TKA).

METHODS

Between March 2013 and March 2016, 30 patients were treated with TKA and bone cement combined with screws for repairing tibial plateau defect. Of the 30 patients, 8 were male and 22 were female, with an average age of 64.7 years (range, 55-71 years). And 17 cases were involved in left knees and 13 cases in right knees; 22 cases were osteoarthritis and 8 cases were rheumatoid arthritis. The disease duration ranged from 9 to 27 months (mean, 14 months). Knee Society Score (KSS) was 41.63±6.76. Hospital for Special Surgery Knee Score (HSS) was 38.10±7.00. The varus deformity of knee were involved in 19 cases and valgus deformity in 11 cases. According to the Rand classification criteria, tibial plateau defect were rated as type Ⅱb.

RESULTS

All incisions healed by first intention, without infection or deep vein thrombosis. All the patients were followed up 27.5 months on average (range, 10-42 months). At last follow-up, HSS score was 90.70±4.18 and KSS score was 93.20±3.75, showing significant differences when compared with preoperative values ( =-58.014, =0.000; =-60.629, =0.000).

CONCLUSION

It is a simple and safe method to repair tibial plateau defect complicated with varus and valgus deformities with bone cement and srews in TKA.

摘要

目的

总结骨水泥联合螺钉修复全膝关节置换术(TKA)中胫骨平台缺损的有效性。

方法

2013年3月至2016年3月,30例患者接受TKA及骨水泥联合螺钉修复胫骨平台缺损治疗。30例患者中,男性8例,女性22例,平均年龄64.7岁(范围55 - 71岁)。左膝17例,右膝13例;骨关节炎22例,类风湿关节炎8例。病程9至27个月(平均14个月)。膝关节协会评分(KSS)为41.63±6.76。特种外科医院膝关节评分(HSS)为38.10±7.00。膝内翻畸形19例,膝外翻畸形11例。根据Rand分类标准,胫骨平台缺损评定为Ⅱb型。

结果

所有切口均一期愈合,无感染或深静脉血栓形成。所有患者平均随访27.5个月(范围10 - 42个月)。末次随访时,HSS评分为90.70±4.18,KSS评分为93.20±3.75,与术前值相比差异有统计学意义(=-58.014,=0.000;=-60.629,=0.000)。

结论

在TKA中,采用骨水泥和螺钉修复合并内翻和外翻畸形的胫骨平台缺损是一种简单、安全的方法。

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