后交叉韧带替代型与保留型全膝关节置换术的早期疗效比较

doi:10.3969/j.issn.1006-7795.2020.04.021

首都医科大学学报 ›› 2020, Vol. 41 ›› Issue (4): 622-626.doi: 10.3969/j.issn.1006-7795.2020.04.021

后交叉韧带替代型与保留型全膝关节置换术的早期疗效比较

曾峥, 刘洋, 王冰

首都医科大学附属北京天坛医院骨科, 北京 100070

收稿日期:2019-10-12 出版日期:2020-08-21 发布日期:2020-07-22
通讯作者: 刘洋 E-mail:liuyangtiantanhospital@163.com
基金资助:
北京市属医院科研培育项目（PX2017066）。

Early efficacy of posterior cruciate-retaining versus posterior cruciate-substituting prosthesis in total knee arthroplasty

Zeng Zheng, Liu Yang, Wang Bing

Department of Orthopedic Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

Received:2019-10-12 Online:2020-08-21 Published:2020-07-22
Supported by:
This study was supported by Beijing Municipal Admnistration of Hospitals Incubating Program, China(PX2017066)

摘要/Abstract

摘要： 目的探讨后交叉韧带替代型与保留型全膝关节置换术的早期疗效。方法回顾性分析2015年8月至2018年7月期间，因膝骨性关节炎行全膝关节置换术的67例患者。其中35例为后交叉韧带保留型（posterior cruciate-retaining，CR）假体，32例为后交叉韧带替代型（posterior cruciate-substituting，PS）假体。观察比较两组患者的手术时间、术后引流量、住院时间、关节活动度、美国特种外科医院膝关节评分（Hospital for Special Surgery knee score，HSS）。结果 PS组患者手术时间（91.77±6.53） min大于CR组（87.48±5.83） min，差异有统计学意义（P<0.05）。PS组术后引流量（315.81±18.34） mL明显大于CR组（203.67±14.59） mL，差异有统计学意义（P<0.05）。在住院时间方面，两组患者间差异无统计学意义（P>0.05）。两组患者术后1、3、6个月的膝关节活动度及HSS差异无统计学意义（P>0.05）。结论 CR及PS假体在膝关节置换术后早期均获得良好的效果。在临床中，应根据患者膝关节的情况和术者的个人经验来选择假体。

关键词: 全膝关节置换术, 后交叉韧带保留型, 后交叉韧带替代型

Abstract: Objective To compare the differences of early clinical efficacy between posterior cruciate-substituting(PS) prosthesis and posterior cruciate-retaining(CR) prosthesis for the patients who underwent total knee arthroplasty(TKA). Methods From August 2015 to July 2018, 67 patients who underwent TKA were retrospectively evaluated. There were 32 PS prosthesis and 35 CR prosthesis. The operation time, postoperative drainage blood volume, hospital stay, range of knee joint motion, and Hospital for Special Surgery knee score (HSS) were recorded. Results The operation time in PS and CR groups was (91.77±6.53) min and (87.48±5.83) min, respectively, with statistical significant differences between the two groups (P<0.05). The postoperative drainage blood volume in PS and CR groups was (315.81±18.34) mL and (203.67±14.59) mL, respectively, with statistical significant difference (P<0.05). There were no differences between the two groups of the hospital stay, range of knee joint motion and HSS (P>0.05). Conclusion The early clinical efficacy of both PS and CR prosthesis after TKA was satisfactory. The choice of TKA prosthesis type should be based on patient conditions and surgeon's experiences.

Key words: total knee arthroplasty, posterior cruciate-retaining, posterior cruciate-substituting

中图分类号:

R687.4

曾峥, 刘洋, 王冰. 后交叉韧带替代型与保留型全膝关节置换术的早期疗效比较[J]. 首都医科大学学报, 2020, 41(4): 622-626.

Zeng Zheng, Liu Yang, Wang Bing. Early efficacy of posterior cruciate-retaining versus posterior cruciate-substituting prosthesis in total knee arthroplasty[J]. Journal of Capital Medical University, 2020, 41(4): 622-626.

参考文献 24

[1]	Da Costa B R, Reichenbach S, Keller N, et al. Retracted:Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis:a network meta-analysis[J]. Lancet, 2017,387(10033):2093-2105.
[2]	毛小成,赵枫,曹杰,等. 半月板旋转型人工膝关节置换中后交叉韧带保留与切除的分析比较[J]. 中国骨与关节损伤杂志,2009,24(8):750-751.
[3]	Koh Y G, Son J, Kwon S K,et al. Preservation of kinematics with posterior cruciate-, bicruciate- and patient-specific bicruciate-retaining prostheses in total knee arthroplasty by using computational simulation with normal knee model[J]. Bone Joint Res,2017,6(9):557-565.
[4]	凌卓彦,李柳炳,董启榕. 全膝关节置换术中切除后交叉韧带的优缺点[J]. 中国骨与关节损伤杂志,2009,24(10):958-960.
[5]	柴伟,任鹏,陈继营,等. 旋转平台后交叉韧带保留型与替代型人工膝关节置换术短期疗效比较[J]. 中华骨与关节外科杂志,2015,8(4):327-331.
[6]	Mazzucchelli L, Deledda D, Rosso F, et al. Cruciate retaining and cruciate substituting ultracongruent insert[J]. Ann Transl Med,2016,4(1):2-8.
[7]	陈奇,陈智,眭杰,等. GEMINI PS全膝关节置换术的初期临床应用[J]. 中国骨与关节损伤杂志,2012,27(8):689-691.
[8]	潘利平,曹永平. 膝关节置换术后的关节摩擦音或弹响[J]. 中国矫形外科杂志,2015,23(3):254-259.
[9]	黄迅,马金忠. 后交叉韧带保留型和后稳定型全膝关节置换术的临床疗效比较研究[J]. 中国骨与关节损伤杂志,2011,26(7):592-594.
[10]	罗世兴,赵劲民,苏伟. 人工全膝关节假体选择的研究进展[J]. 中国修复重建外科杂志,2010,24(3):301-303.
[11]	刘军,甄平,周胜虎,等. 类风湿关节炎行关节置换术围手术期管理的研究进展[J]. 中国骨伤,2017,30(11):1067-1073.
[12]	Indelli P F, Marcucci M, Graceffa A, et al. Primary posterior stabilized total knee arthroplasty:analysis of different instrumentation[J]. J Orthop Surg Res,2014,9(1):1-5.
[13]	刘扬波,袁健东,陈成帷,等. 改良型股骨假体对降低初次后稳定型全膝关节置换术后髌骨弹响综合征发生率的病例对照研究[J]. 中国骨伤,2014,27(4):278-282.
[14]	孙长鲛,周勇刚. 膝关节置换术后失败的原因分析[J]. 中华关节外科杂志:电子版,2014,8(5):652-658.
[15]	Bueehel F F Sr. Long-term follow-up after mobile-bearing total knee repalement[J]. Clin Orthop Relat Res, 2002,404:40-50.
[16]	Yagishita K, Muneta T, Ju Y J, et al. High-flex posterior crutiate-retaining vs posterior crudiate-substituing designs in simultaneous bilateral total knee arthroplasty:a prospective, randonmized study[J]. J Arthroplasty. 2012,27(3):368-374.
[17]	Chaudhary R, Beaupre L A, Johnston D W. Knee range of motion during the first two years after use of posterior cruciate-stabilizing or posterior cruciate-retaining total knee prostheses. A randomized clinical trial[J]. J bone Joint Surg Am, 2008,90(12):2579-2586.
[18]	Luo H G, Zhu W, Zhang Z X. Comparison of Outcomes After Bilateral Simultaneous Total Knee Arthroplasty Using Posterior-Substituting Versus Cruciate-Retaining Prostheses[J].Saudi Med J, 2015, 36(2):190-195.
[19]	Kim Y H, Choi Y, Kwon O R, et al. Functional outcome and range of motion of high-flexion posterior cruciate-retaining and high-flexion posterior cruciate-substituting total knee prostheses. A prospective randomized study[J]. J Bone Joint Surg Am, 2009, 91(4):753-760.
[20]	Mayne A, Harshavardhan H P, Johnston L R, et al. Cruciate retaining compared with posterior stabilized Nexgen total knee arthroplasty:results at 10 years in a matched cohort[J]. Ann R Coll Surg Engl, 2017,99(8):602-606.
[21]	Jiang C, Liu Z, Wang Y, et al. Posterior cruciate ligament retention versus posterior stabilization for total knee arthroplasty:a meta-analysis[J]. Plos One, 2016, 11(1):e0147865.
[22]	Seon J K, Park J K, Shin Y J, et al. Comparisons of kinematics and range of motion in hige-flexion total knee arthroplasty:cruciate retaining vs. substituting designs[J]. Knee Surg Sports Traumatol Arthrosc, 2011, 19(12):2016-2022.
[23]	Rand J A,Trousdale R T,Ilstrup D M,et al.Factors affecting the durability of primary total knee prostheses[J].J Bone Joint Surg Am,2003,85(2):259-265.
[24]	Abdel M P,Morrey M E,Jensen M R,et al. Increased long-term survival of posterior cruciate-retaining versus posterior cruciate-stabilizing total knee replacements[J].J Bone Joint Surg Am,2011,93(22):2072-2078.

后交叉韧带替代型与保留型全膝关节置换术的早期疗效比较

Early efficacy of posterior cruciate-retaining versus posterior cruciate-substituting prosthesis in total knee arthroplasty

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