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在传统全膝关节置换术中，使用编织缝线进行连续锁定缝合对关节切开术修复是否足够？一项随机对照试验研究。

Is continuous locking suture with braided suture sufficient for arthrotomy repair in the conventional TKR? A randomized controlled trial study.

作者信息

Wongsak Siwadol, Chulsomlee Kulapat, Jarungvittayakon Chavarat, Jaovisidha Suphaneewan, Sa-Ngasoongsong Paphon

机构信息

Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI Road, Thung Phaya Thai, Ratchathewi District, Bangkok, 10400, Thailand.

Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 111 Suwannabhumi Canal Road, Bang Pla, Bang Phli District, Samut Prakan, 10540, Thailand.

出版信息

J Orthop. 2021 Feb 12;24:47-53. doi: 10.1016/j.jor.2021.02.011. eCollection 2021 Mar-Apr.

DOI:10.1016/j.jor.2021.02.011
PMID:33679027
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7907677/
Abstract

INTRODUCTION

Medial-parapatellar-arthrotomy is the standard approach for total knee replacement(TKR). No studies have clarified the outcomes as quadriceps-strength-recovery (QS) and safety of Continuous-locking-suture-technique(CLS) for the arthrotomy-repair.

METHODS

Patients were randomly assigned into a CLS(n = 40) and an interrupted-horizontal-mattress(IHM, n = 40). QS, visual-analog-scale(VAS), modified-timed-up-and-go(TUGT) test, Western-Ontario-and McMasters-Universities-Osteoarthritis-Index[WOMAC] and Knee-Society-Score[KSS] were followed for 6 months'.

RESULTS

A significantly-shorter capsular-closure-time in CLS(233 ± 40 VS 388 ± 47 sec)(p < 0.0001). There were insignificant difference in QS, VAS, TUGT, WOMAC and KSS during the 6-month follow-up period(p > 0.05 all). No wound complications were found.

CONCLUSION

CLS with braided-suture is safe and effective as demonstrated a recovery of the QS and knee function outcome comparable to IHM.

TRIAL REGISTRATION

This study was registered in Thai Clinical Trials Registry on December 2015 (https://www.clinicaltrials.in.th). The registration number was TCTR20151208003.

摘要

引言

髌旁内侧关节切开术是全膝关节置换术（TKR）的标准入路。尚无研究阐明连续锁定缝合法（CLS）用于关节切开修复时股四头肌力量恢复（QS）情况及安全性。

方法

将患者随机分为连续锁定缝合法组（n = 40）和间断水平褥式缝合法组（IHM，n = 40）。对QS、视觉模拟评分法（VAS）、改良计时起立行走测试（TUGT）、西安大略和麦克马斯特大学骨关节炎指数[WOMAC]以及膝关节协会评分[KSS]进行为期6个月的随访。

结果

连续锁定缝合法组的关节囊闭合时间显著缩短（233 ± 40秒对388 ± 47秒）（p < 0.0001）。在6个月的随访期内，QS、VAS、TUGT、WOMAC和KSS方面差异无统计学意义（p均> 0.05）。未发现伤口并发症。

结论

编织缝线连续锁定缝合法安全有效，其股四头肌力量恢复及膝关节功能结果与间断水平褥式缝合法相当。

试验注册

本研究于2015年12月在泰国临床试验注册中心注册（https://www.clinicaltrials.in.th）。注册号为TCTR20151208003。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/7907677/64bd78a05259/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/7907677/a7638109c17b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/7907677/566f582f7346/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/7907677/d13504885897/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/7907677/c783a7e962bb/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/7907677/2fae7a04c43c/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/7907677/64bd78a05259/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/7907677/a7638109c17b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/7907677/566f582f7346/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/7907677/d13504885897/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/7907677/c783a7e962bb/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/7907677/2fae7a04c43c/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/7907677/64bd78a05259/gr6.jpg

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本文引用的文献

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全膝关节置换术保留股四头肌与传统髌旁内侧入路的比较：一项荟萃分析
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The effects of barbed suture on watertightness after knee arthrotomy closure: a cadaveric study.倒刺缝线对膝关节切开术后伤口水密性的影响：一项尸体研究。
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Comparison of mini-subvastus approach versus medial parapatellar approach in primary total knee arthroplasty.小隐静脉下入路与髌旁内侧入路在初次全膝关节置换术中的比较。
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