外侧副韧带松弛的内翻膝患者在TKA术中的胫骨截骨量分析

目的　探讨合并外侧副韧带松弛的内翻膝患者的截骨量是否受影响。 方法　选取本院2016年至2018年行膝关节置换的内翻膝患者92例，其中25例合并外侧副韧带松弛的患者为观察组；其余患者为对照组。两组均采用等量截骨法进行截骨。术中测量股骨远端外髁、股骨后外髁、胫骨外侧平台截骨量，随访测量胫股解剖角（anatomic tibiofemoral angle，ATFA）、髌骨倾斜角（patellar tilt angle，PTA）、股骨后髁偏距（posterior condylar offset，PCO）。采用美国膝关节协会评分（AKS）、美国特种外科医院（HSS）评分以及关节活动度评价关节功能。 结果　两组股骨远端外髁截骨量差异无统计学意义（P>0.05），观察组术中胫骨外侧平台截骨量低于对照组（P<0.05）。两组患者术后6周、6个月及12个月ATFA、PTA、PCO、AKS评分、HSS评分及膝关节活动度无统计学差异（P>0.05）。 结论　合并外侧副韧带松弛的内翻膝患者的胫骨外侧平台截骨量较小。

Analysis of tibial osteotomy in varus knee patients with lateral collateral ligament relaxation during TKA

Objective　To investigate whether osteotomy of varus knee patients with lateral collateral ligament relaxation is affected.　Methods　Ninety-two patients with varus knee joint replacement went to our hospital from 2016 to 2018 were selected, among which 25 patients with lateral collateral ligament relaxation were as an observation group and the rest were as a control group. Both groups were treated with equal osteotomy. The osteotomy of the distal femoral condyle, the posterior femoral condyle and the lateral tibial plateau were measured during the operation. Anatomic tibiofemoral angle (ATFA), patellar tilt angle (PTA) and posterior condylar offset (PCO) were measured during the follow-up. The joint function was evaluated by the American Knee association score (AKS), the American Special Surgery Hospital (HSS) score and joint mobility.　Results　There was no significant difference in the osteotomy of the distal femoral condyle between the two groups (P>0.05). The osteotomy of the lateral tibial plateau in the observation group was lower than that in the control group (P<0.05). There was no statistical difference in ATFA, PTA, PCO, AKS, HSS and knee activity at 6 weeks, 6 months and 12 months after operation between the two groups (P>0.05).　Conclusions　The patients with varus knee combined with lateral collateral ligament relaxation had less osteotomy volume of the lateral tibial plateau .