Wang Shangzeng, Wu Shengchao, You Mingcan, Li Qiang, Zheng Fuzeng
Department of Orthopaedics, the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou Henan, 450002, P.R.China.
Postgraduate School, Henan University of Traditional Chinese Medicine, Zhengzhou Henan, 450046, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Dec 15;31(12):1423-1427. doi: 10.7507/1002-1892.201707071.
To evaluate the effectiveness of one-stage total knee arthroplasty (TKA) for femoral supracondylar fracture combined with knee osteoarthritis.
Between January 2012 and March 2015, a total of 19 patients (19 knees) with femoral supracondylar fracture and knee osteoarthritis were treated with one-stage TKA. Of 19 cases, 8 were male and 11 were female with an average age of 69.6 years (range, 60-85 years). The mean body mass index was 22.6 kg/m (range, 22.0-27.5 kg/m ). The left knee was involved in 13 cases, and the right knee in 6 cases. The causes of femoral supracondylar fracture were falls in 10 cases, traffic accidents in 8 cases, and other injury in 1 case. All fractures were classified as type A according to AO/Association for the Study of Internal Fixation (AO/ASIF) classification. The interval of injury and operation was 4-13 days (mean, 8.6 days). The disease duration of osteoarthritis ranged from 30 to 90 months (mean, 52.6 months). During follow-up, the knee society score (KSS) and the range of motion (ROM) were used to evaluate the knee function; anteroposterior and lateral X-ray films of the knee were used to observe the position of the prosthesis.
All the incisions healed at the first stage, and there was no early complication such as pulmonary infection, pressure ulcer, and urinary tract infection. All patients were followed up 2-4 years with an average of 2.6 years. The ROM and KSS functional scores and clinical scores were significantly improved at 15 days and 2 years after operation, showing significant differences when compared with those before operation ( <0.05). There were significant differences in the ROM and KSS functional scores and clinical scores between two time points after operation ( <0.05). X-ray films showed the fracture bone healing, good alignment, no loosening of prosthesis at 2 years after operarion.
One-stage TKA for femoral supracondylar fracture combined with knee osteoarthritis can achieve good effectiveness. It can not only reconstruct joint function, but also cure osteoarthritis and fracture at the same time, shorten the healing time, reduce the incidence of related complications.
评估一期全膝关节置换术（TKA）治疗股骨髁上骨折合并膝关节骨关节炎的有效性。
2012年1月至2015年3月，共19例（19膝）股骨髁上骨折合并膝关节骨关节炎患者接受一期TKA治疗。19例中，男性8例，女性11例，平均年龄69.6岁（范围60 - 85岁）。平均体重指数为22.6 kg/m²（范围22.0 - 27.5 kg/m²）。左膝13例，右膝6例。股骨髁上骨折的原因：跌倒10例，交通事故8例，其他损伤1例。所有骨折根据AO/国际内固定研究学会（AO/ASIF）分类均为A型。受伤至手术间隔时间为4 - 13天（平均8.6天）。骨关节炎病程为30至90个月（平均52.6个月）。随访期间，采用膝关节协会评分（KSS）和活动范围（ROM）评估膝关节功能；膝关节正侧位X线片观察假体位置。
所有切口一期愈合，未发生肺部感染、压疮、尿路感染等早期并发症。所有患者均随访2 - 4年，平均2.6年。术后15天和2年时ROM、KSS功能评分及临床评分均显著改善，与术前相比差异有统计学意义（P <0.05）。术后两个时间点的ROM、KSS功能评分及临床评分差异有统计学意义（P <0.05）。X线片显示术后2年骨折骨性愈合，对位良好，假体无松动。
一期TKA治疗股骨髁上骨折合并膝关节骨关节炎可取得良好疗效。不仅能重建关节功能，还能同时治愈骨关节炎和骨折，缩短愈合时间，降低相关并发症的发生率。
