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1、高屈曲人工全膝关节表面置换术临床研究作者:何森曹文作者单位:天津市天和医院骨科,天津300050【摘要】耳的:探讨应用高屈曲型假体行人工全膝关节置换术的早期临床效果。方法:200212〜20063月间,对125例(213膝)患者用LPSFLEX高屈曲型假体行TKAo其屮男36例(62膝),女89例(151膝),年龄51〜85岁,平均681岁。骨性关节炎90例(149膝),类风湿性关节炎35例(64膝)。所有病人均行常规離骨置换,假体均采用骨水泥固定。结果:术后第一天即开始康复训练,伤口均一期愈合。随访12
2、〜52个月,平均34个月。2例因早期屈曲不佳(<90°)于术后6周在连续硬膜外麻醉下行手法松解后获得满意屈曲度,2例发生感染,其余均疗效优良。随访X线片结合临床均无感染、假体松动、假体周围骨折、骨吸收及脱位发生。HSS评分由术前30〜65分,平均48分,提高至术后85-98分,平均91分。结论:LPSFLEX高屈曲型假体在高屈曲位时仍在胫骨上保持面接触,且胫骨CAM始终在股骨SPINE的基部,从而在获得最大屈曲的同时保持了良好的稳定性。【关键词】全膝关节表面置换术;高屈曲;假体;关节活动度Clinical
3、StudyonHighFlexTotalKneeArthroplastyHESen,CAOWenDepartmentofOrthopaedicSurgery,TianjinTianheHospital,Tianjin,300050,China[ABSTRACT】Objective:ToinvestigatetheearlyclinicaleffectivenessafterHighFlex(LPSFLEX)totalkneeathroplasty.Methods:FromDecember2002toMar
4、ch2006,213kneesamong215atientswereperformedHighFlextotalkneearthroplasty.Therewere36maleswith62kneesand89femaleswith151knees,andtheaverageageofthepatientswas681rangingfrom51to85.Thediagnosisofthepatientswasosteoarthritisin90cases(149knees),rheumatoidarthr
5、itisin35cases(64knees).Regularpatellarreplacementwasperformedandalloftheprostheseswerefixedbycement・Results:Onthefirstdayafteroperation,rehabilitationwasbegun,thewoundhealedinonestageinallthepatientsandtheywerefollowedupfrom12to52monthswiththeaverageof34m
6、onths.TheHSSkneescorewasimprovedfrompreoperative30〜65withaverageof48topostoperative85-98withaverageof9l.Twopatientsreceivedmanipulationsunderanaesthesiasixweeksafteroperationsbecauseofunsatisfactoryflexionandtheresultswerefine.Therewereinfectionsintwopati
7、ents.Nolooseningoftheprostheses,fracture,obsorbingofbonesanddislocationswerefoundinothercasesatfinalfollowup.Conclusion:TheprosthesesofHighFlexextendedposteriorcondylaronthefemoralcomponenttofacilitatetibiofemoralcontacttosupporthighflexionupto155.Atthesa
8、metime,amodifiedcam/spinemechanismallowedstability,posteriorclearanceandprotectionagainstsubluxationduringdeepflexion.Theresultoftheinitialreportswasexcellent.Thereforebetterlongtermresultscouldbeexpected・【KEYWORDS】