山东医药2017，Vol.57Issue(16)：1-4,4.DOI:10.3969/j.issn.1002-266X.2017.16.001
膝关节翻修术后关节线变化对膝关节功能的影响
Effects of changes of knee joint line position on clinical function of knee after revision TKA
摘要
Abstract
Objective To evaluate the effects of changes of the knee joint line position on the clinical function of knee after revision total knee arthroplasty (R-TKA).Methods Eighty-nine patients (89 knees) who underwent R-TKA were treated with LCCK condylar limited knee prosthesis for R-TKA.The changes of knee joint line were measured on the basis of X-ray before and 24 months after surgery.The knee score, function score, Feller patella score and knee range of motion (ROM) were measured before and after operation in patients with changes of knee joint line (≤2, >2-≤4, and>4 mm).The changes of joint line in patients between using tibia, femur metal augmentation or not were compared as well as the knee function-related indicators.Results Seventy cases elevated (range from 0.4 to 8.9 mm) and 19 cases declined (range from-4.1 to-0.3 mm), including 23 cases with joint line change of ≤2 mm, 42 cases with change of >2-≤4 mm and 31 cases with change of >4 mm.The postoperative knee score, function score, Feller score and knee range of motion in patient with the same joint line change were increased as compared with the preoperative ones (all P<0.01).However, the postoperative knee score, function score and Feller score in cases whose joint line change was less than 2 mm and more than 2 to less than 4 mm were higher than those of the cases whose joint line change was >4 mm (all P<0.01).Forty patients used the femur metal augmentation and 49 patients did not use in 89 patients.The postoperative joint line changes were-4.1-7.9 (1.9±3.4) mm and 2.2-8.9 (3.5±3.4) mm, respectively (P<0.05).Fourteen patients used the tibia metal augmentation and 75 patients did not use, and no significant difference was found in the joint line changes (P>0.05).Patients with femur metal augmentation had higher postoperative functional score and Feller patella score than those of the untreated ones (P<0.05 or P<0.01).There was no significant difference in knee score, function score, Feller patella score and knee ROM between patients with and without femur metal augmentation (all P>0.05).Conclusions The joint line changed within 4 mm can result in a better knee joint function after R-TKA.Intraoperative use of femur metal augmentation is conducive to reducing the joint line changes and improving knee function, while the tibial side of the metal augmentation has no significant effect.关键词
膝关节翻修术/关节线/金属填充块/胫骨/股骨/关节功能Key words
revision total knee arthroplasty/joint line/metal augmentation/tibia/femur/joint function分类
医药卫生引用本文复制引用
及松洁,姜旭,李玉军,黄野,周一新..膝关节翻修术后关节线变化对膝关节功能的影响[J].山东医药,2017,57(16):1-4,4.基金项目
国家自然科学基金资助项目(81472139). （81472139）
