旋转平台与后稳定固定平台膝关节假体分析

目的比较分析旋转平台、后稳定固定平台膝关节假体对初次单侧膝关节置换患者术后患肢功能恢复的影响。 方法回顾性分析初次行单侧膝关节置换术的350例膝关节病患者临床资料。纳入病例均经临床、X线片或CT确诊。其中选择旋转平台膝关节假体180例设为A组，选择后稳定固定平台膝关节假体170例设为B组，比较两组手术前后美国特种外科医院膝关节评分(HSS)、美国膝关节协会评分(KSS)、膝关节屈曲度(ROM)及静态稳定性指标，记录两组并发症情况。其中HSS、KSS、ROM、静态稳定性指标等计量资料行t检验，并发症等计数资料行χ²检验。 结果两组术后6个月HSS评分、KSS评分、ROM、横轴向躯体重心(GCP)偏移位置均较术前显著上升，GCP漂移轨迹均显著减少，差异有统计学意义(A组手术前后t ＝－105.415、－107.890、－23.829、56.647、78.339；B组手术前后t ＝－103.736、－136.420、－22.141、－26.077、69.119，均为P<0.05)；A组术后6个月GCP漂移轨迹显著小于B组(t ＝7.082，P<0.05)；两组并发症发生率比较差异无统计学意义(χ² ＝2.361，P>0.05)。 结论旋转平台与后稳定固定平台假体均能明显促初次单侧膝关节置换患者术后患肢功能恢复，并发症类似，但前者相对静态稳定性更好。

Analysis of rotating platform and posterior stabilized platform knee prostheses

ObjectiveTo comparatively analyze the effect of rotating platform and posterior stabilized platform knee prostheses on limb function recovery after initial unilateral knee replacement. MethodsThe clinical data of 350 patients undergoing initial unilateral knee replacement were analyzed retrospectively. All the cases were confirmed by clinic, X-ray or CT. Among them, 180 patients with rotating platform knee prostheses were included in group A, and 170 patients with posterior stabilized platform knee prostheses were included in group B. The knee score of Hospital for Special Surgery (HSS), the Knee Society Association (KSS) score, knee flexion (range of motion, ROM) and static stability indexes were compared between the two groups. The incidence of complications in the two groups was recorded. The t test was performed on HSS, KSS, ROM, static stability indicators and other measurement data, and chi-square test was performed on complications and other enumeration data. ResultsThe HSS scores, KSS scores, ROM and deviation position of transverse gravity center position (GCP) of both groups were significantly increased at six months after the surgery while drifting trajectory of GCP was significantly decreased (comparison between the data before and after the operation: group A, t =-105.415, -107.890, -23.829, 56.647, 78.339; group B, t=-103.736, -136.420, -22.141, -26.077, 69.119, all P<0.05). The drifting trajectory of GCP in group A at six months after surgery was significantly smaller than that in group B (t=7.082, P <0.05). There was no significant difference between the two group in the incidence of complications (χ²=2.361, P >0.05). ConclusionBoth of rotating platform and posterior stabilized platform prostheses can significantly promote limb function recovery in the patients undergoing primary unilateral knee replacement; the complications are similar but the static stability of the former is relatively better.