[1]王琦,王国栋,马龙飞,等.旋转平台与固定平台假体全膝人工关节置换术的早期疗效比较[J].中华老年骨科与康复电子杂志,2019,(02):93-98.[doi:10.3877/cma.j.issn.2096-0263.2019.02.006]
 Wang Qi,Wang Guodong,Ma Longfei,et al.Comparison of early clinical outcomes between rotating platform and fixed platform prosthesis in total knee arthroplasty: a short-term result[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(02):93-98.[doi:10.3877/cma.j.issn.2096-0263.2019.02.006]
点击复制

旋转平台与固定平台假体全膝人工关节置换术的早期疗效比较()
分享到:

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2019年02期
页码:
93-98
栏目:
膝关节
出版日期:
2019-04-05

文章信息/Info

Title:
Comparison of early clinical outcomes between rotating platform and fixed platform prosthesis in total knee arthroplasty: a short-term result
作者:
王琦王国栋马龙飞谢士成赵晓伟张元民
272029 济宁医学院附属医院骨关节科
Author(s):
Wang Qi Wang Guodong Ma Longfei Xie Shicheng Zhao Xiaowei Zhang Yuanmin
Department of Bone and Joint Surgery, Affiliated Hospital of Jining Medical University, Jining 272029, China
关键词:
关节成形术置换 膝关节假体 骨性关节炎
Keywords:
Arthroplasty replacement knee Knee prosthesis Osteoarthritis
DOI:
10.3877/cma.j.issn.2096-0263.2019.02.006
文献标志码:
A
摘要:
目的 比较全膝人工关节置换术应用强生旋转平台与固定平台两种假体术后早期临床疗效。方法 回顾性收集2017年1月至2018年01月济宁医学院附属医院收治的79例86侧膝关节骨性关节炎患者进行回顾性研究,其中43例46膝应用强生旋转平台,其中男性18例(18膝,39.13%),女性25例(28膝,60.87%);左侧25膝(54.35%),右膝21膝(45.65%),年龄为55~77岁,平均(68±8)岁。36例(40膝)应用强生固定平台,其中男性16例(17膝,42.50%),女性20例(23膝,57.50%);左侧22膝(55.00%),右膝18膝(45.00%)。年龄为54~80岁,平均(67±8)岁。所有患者均由同一位医师行固定平台假体或旋转平台假体初次TKA术。分别于手术前后评估膝关节HSS评分、膝关节活动度。结果 固定平台组或旋转平台组患者的术前活动度与末次随访活动度相比,差异均具有统计学意义(t=26.801,t=21.470,P<0.05);固定平台组或旋转平台组患者的术前HSS评分与末次随访HSS评分相比,差异均具有统计学意义(t=35.180,t=35.053,P<0.05)。固定平台组与旋转平台组患者比较,术前及末次随访活动度差异均无统计学意义(均P>0.05),固定平台组与旋转平台组患者比较,术前及末次随访HSS评分差异均无统计学意义(均P>0.05)。结论 旋转平台假体与固定平台假体TKA术后早期临床总体疗效相似。两种假体均能明显改善膝关节活动度及膝关节功能。无论使用哪种假体,短期随访时间内都不会影响到效果。
Abstract:
Objective To compare the early postoperative clinical outcomes of rotating platform and fixed platform prosthesis in total knee arthroplasty. Methods A retrospective study was performed on 79 patients (86 cases) with diagnosis of knee osteoarthritis from January 2017 to January 2018, including 43 patients with 46 knees using a rotating platform, thereinto 18 males with 18 knees (39.13%), 25 females with 28 knees (60.87%). 25 left knee (54.35%), 21 right knee (45.65%), age range was 55 to 77 years old, and the average was (68±8) years old. 36 patients (40 knee) using a fixed platform, including 16 males with 17 knees (42.50%), 20 females with 23 knees (57.50%), 22 left knee (55.00%), 18 right knee (45.00%), age range was 54 to 80 years old and the average was (67±8) years old. All patients underwent primary TKA with a fixed platform prosthesis or a rotating platform prosthesis. The knee joint HSS score and range of motion of knee were evaluated before and after surgery. Results The preoperative range of motion of knee in the fixed platform group or the rotating platform group was statistically different with the last follow-up range of motion of knee (t=26.801, t=21.470, P<0.05).The preoperative HSS scores of the patients in the fixed platform group or the rotating platform group were statistically different compared with the last follow-up HSS score (t=35.180, t=35.053, P<0.05). There was no significant difference in range of motion of knee between the fixed platform group and the rotating platform group at preoperative and the last follow-up. There was no significant difference in the HSS between the fixed platform group and the rotating platform group at preoperative and the last follow-up. Conclusions The overall clinical efficacy of the rotating platform prosthesis and the fixed platform prosthesis in total knee arthroplasty was similar. Both prostheses significantly improved mobility and function of knee compared to preoperative. No matter which type of prosthesis was used, it will not affect the clinical effect during short-term follow-up.

参考文献/References:

1 杨兆先. 不同分期膝关节骨性关节炎治疗方案探讨 [J]. 中国骨科临床与基础研究杂志, 2015, 7(1): 48-52.
2 何志勇, 吴海山, 吴宇黎, 等. 关节镜下有限与广泛清理术治疗膝骨性关节炎的临床比较 [J]. 中国矫形外科杂志, 2004, 12(15): 1130-1132.
3 王坤正. 浅谈中国关节置换外科的现状与未来 [J]. 中华关节外科杂志:电子版, 2015, 9(6): 703-706.
4 Bhattacharya R, Scott CE, Morris HE, et al. Survivorship and patient satisfaction of a fixed bearing unicompartmental knee arthroplasty incorporating an all-polyethylene tibial component [J]. Knee, 2012, 19(4): 348-351.
5 Kim YH, Park JW, Kim JS. Clinical Results of Fixed-Bearing and Rotating-Platform Total Knee Prostheses [J]. Orthopedics, 2018, 41(2): 88-94.
6 Goldstein WM, Gordon AC, Youderian A, et al. Mid-term survivorship results for a rotating-platform knee prosthesis [J]. Orthopedics, 2011, 34(1): 16.
7 Huang CH, Liau JJ, Cheng CK. Fixed or mobile-bearing total knee arthroplasty [J]. J Orthop Surg Res, 2007, 5(2): 1.
8 Silvestre Munoz A, Almeida Herrero F, Lopez Lozano R, et al. Comparison of mobile- and fixed-bearing cemented total knee arthroplasty [J]. Acta Orthop Belg, 2008, 74(6): 801-808.
9 陈廖斌, 王华, 王欣, 等. 旋转平台与固定平台全膝关节置换术的对比研究及髌骨置换与否对疗效的影响 [J]. 中华关节外科杂志:电子版, 2010, 4(6): 742-747.
10 Ranawat AS, Rossi R, Loreti I, et al. Comparison of the PFC sigma fixed-bearing and rotating-platform total knee arthroplastyin the same patient [J]. J Arthroplasty, 2004, 19(1): 35-39.
11 Ranawat CS, Flynn WF, Saddler S, et al. Long-term results of the total condylar knee arthroplasty. A 15-year survivorship study [J]. Clin Orthop Relat Res, 1993, (286): 94-102.
12 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.
13 Ranawat CS, Komistek RD, Rodriguez JA, et al. In vivo kinematics for fixed and mobile-bearing posterior stabilized knee prostheses [J]. Clin Orthop Relat Res, 2004 (418): 184-190.
14 Rees JL, Beard DJ, Price AJ, et al. Real in vivo kinematic differences between mobile-bearing and fixed-bearing total knee arthroplasties [J]. Clin Orthop Relat Res, 2005 (432): 204-209.
15 Rönn K, Reischl N, Gautier E, et al. Current surgical treatment of knee osteoarthritis [J]. Arthritis, 2011, 2011: 454873.
16 孙启彬, 王玉. 膝关节镜下有限清理与广泛清理术治疗膝关节骨关节炎的疗效对比 [J]. 中国老年学杂志, 2014, 34(2): 367-369.
17 Carothers JT, Kim RH, Dennis DA, et al. Mobile-Bearing total knee arthroplasty a meta-analysis [J]. J Arthroplasty, 2011, 26(4): 537-542.
18 李金龙, 李为, 樊大钊, 等. 后方稳定型全膝人工关节置换术30例分析 [J]. 中国矫形外科杂志, 2007, 15(21): 1656-1658.
19 丘立标, 彭伟秋, 李富明, 等. 中年膝骨性关节炎全膝关节置换中应用旋转高屈曲型假体的特点 [J]. 中国组织工程研究, 2016, 20(17): 2467-2473.
20 Woolson ST, Epstein NJ, Huddleston JI. Long-Term comparison of Mobile-Bearing vs Fixed-Bearing total knee arthroplasty [J]. Journal of Arthroplasty, 2011, 26(8): 1219-1223.
21 Oh KJ, Pandher DS, Lee SH, et al. Meta-analysis comparing outcomes of Fixed-Bearing and Mobile-Bearing prostheses in total knee arthroplasty [J]. J Arthroplasty, 2009, 24(6): 873-884.
22 Hasegawa M, Sudo A, Uchida A. Staged bilateral mobile-bearing and fixed-bearing total knee arthroplasty in the same patients: a prospective comparison of a posterior-stabilized prosthesis [J]. Knee Surg Sports Traumatol Arthrosc, 2009, 17(3): 237-243.
23 Breugem SJ, Sierevelt IN, Schafroth MU, et al. Less anterior knee pain with a mobile-bearing prosthesis compared with a fixedbearing prosthesis [J]. Clin Orthop Relat Res, 2008, 466(8): 1959-1965.
24 Dennis DA, Komistek RD, Mahfouz MR, et al. A multicenter analysis of axial femorotibial rotation after total kneearthroplasty [J]. Clin Orthop Relat Res, 2004, (428): 180-189.
25 Kim YH, Yoon SH, Kim JS. The long-term results of simultaneous fixed-bearing and mobile-bearing total knee replacements performed in the same patient [J]. J Bone Joint Surg Br, 2007, 89(10): 1317-1323.

相似文献/References:

[1]徐明 付志厚 孙海宁 曲新涛 于秀淳.腓骨近端截骨与单髁关节置换治疗膝关节内侧单间室骨关节炎的疗效比较[J].中华老年骨科与康复电子杂志,2016,(01):26.[doi:10.3877/cma.j.issn.2096-0263.2016.01.006]
 Xu Ming,Fu Zhihou,Sun Haining,et al.Comparison study of proximal fibular osteotomy versus unicompartmental knee arthroplasty for medialcompartment osteoarthritis of the knee[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):26.[doi:10.3877/cma.j.issn.2096-0263.2016.01.006]
[2]李雪靖,张雪松,刘思思,等.腓骨近端截骨联合关节镜下清理治疗内翻型膝关节骨关节炎的成本效果分析[J].中华老年骨科与康复电子杂志,2016,(04):222.[doi:10.3877/cma.j.issn.2096-0263.2016.04.006]
 Li Xuejing,Zhang Xuesong,Liu Sisi,et al.Cost-effectiveness analysis of proximal fibular osteotomy combined with arthroscopy debridement for medial compartment knee ostoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):222.[doi:10.3877/cma.j.issn.2096-0263.2016.04.006]
[3]张静,李志锐,唐佩福.老年粗隆间骨折的手术治疗进展[J].中华老年骨科与康复电子杂志,2016,(04):250.[doi:10.3877/cma.j.issn.2096-0263.2016.04.011]
 Li Zhirui,Zhang Jing,Tang Peifu.Progress of surgical treatment for femoral intertrochanteric fracture in the elderly patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):250.[doi:10.3877/cma.j.issn.2096-0263.2016.04.011]
[4]李涛,王英振,李玉龙,等.骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折安全性的 Meta分析[J].中华老年骨科与康复电子杂志,2017,(02):109.[doi:10.3877/cma.j.issn.2096-0263.2017.02.008]
 Li Tao,Wang Yingzhen,Li Yulong,et al.Safety of cement and cementless hemiarthroplasty for femoral neck fractures in elderly patients: a meta- analysis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(02):109.[doi:10.3877/cma.j.issn.2096-0263.2017.02.008]
[5]陈佳,李西成.髋部骨折:争议与挑战[J].中华老年骨科与康复电子杂志,2017,(04):193.[doi:10.3877/cma.j.issn.2096-0263.2017.04.001]
 Chen Jia,Li Xicheng.Hip fracture: Controversy and challenge[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(02):193.[doi:10.3877/cma.j.issn.2096-0263.2017.04.001]
[6]贾建波,禹宝庆,吴良浩,等.传统后路与微创 SuperPath入路的半髋置换治疗老年股骨颈骨折疗效比较[J].中华老年骨科与康复电子杂志,2017,(04):223.[doi:10.3877/cma.j.issn.2096-0263.2017.04.006]
 Jia Jianbo,Yu Baoqing,Wu Lianghao,et al.Hip hemiarthroplasty for senile femoral neck fractures: minimally invasive SuperPath approach versus traditional posterior approach[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(02):223.[doi:10.3877/cma.j.issn.2096-0263.2017.04.006]
[7]扈鑫,高石军,董江涛,等.中老年全膝关节置换术后下肢深静脉血栓形成的解剖部位分布特点[J].中华老年骨科与康复电子杂志,2017,(05):296.[doi:10.3877/cma.j.issn.2096-0263.2017.05.009]
 Hu Xin,Gao Shijun,Dong Jiangtao,et al.The anatomical distribution of lower extremity deep vein thrombosis of middle-aged, and older patients after total knee arthroplasty[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(02):296.[doi:10.3877/cma.j.issn.2096-0263.2017.05.009]
[8]姚尧,乔梁,王业贤,等.床旁超声在股骨颈骨折患者围手术期下肢深静脉血栓筛查中的作用[J].中华老年骨科与康复电子杂志,2018,(02):70.[doi:10.3877/cma.j.issn.2096-0263.2018.02.002]
 Yao Yao,Qiao Liang,Wang Yexian,et al.The clinical value of bedside ultrasound in the screening of perioperative lower extremity deep vein thrombosis in elderly patients with femoral neck fracture[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(02):70.[doi:10.3877/cma.j.issn.2096-0263.2018.02.002]
[9]楚翔宇,程文俊,王俊文,等.老年股骨颈骨折全髋关节置换术围手术期下肢深静脉血栓形成的特点[J].中华老年骨科与康复电子杂志,2018,(02):75.[doi:10.3877/cma.j.issn.2096-0263.2018.02.003]
 Chu Xiangyu,Cheng Wenjun,Wang Junwen,et al.Features of deep venous thrombosis in aged patients with femoral neck fracture during the perioperative period[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(02):75.[doi:10.3877/cma.j.issn.2096-0263.2018.02.003]
[10]董航,沈先月,李昊轩,等.基于三维重建技术的国人肩关节盂三维形态学测量与研究[J].中华老年骨科与康复电子杂志,2018,(02):98.[doi:10.3877/cma.j.issn.2096-0263.2018.02.007]
 Dong Hang,Shen Xianyue,Li Haoxuan,et al.Morphological measurement and analysis of normal glenoid fossa in Chinese population by application of three-dimensional reconstruction[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(02):98.[doi:10.3877/cma.j.issn.2096-0263.2018.02.007]
[11]李森磊,孙立,杨先腾,等.老年髋关节置换术后认知功能障碍的危险因素分析[J].中华老年骨科与康复电子杂志,2016,(02):71.[doi:10.3877/cma.j.issn.2096-0263.2016.02.002]
 Li Senlei,Sun Li,Yang Xianteng,et al.Risk factors analysis for postoperative cognitive dysfunction in  elderly patients undergoing hip arthroplasty[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):71.[doi:10.3877/cma.j.issn.2096-0263.2016.02.002]
[12]李梦远,陈宏 马元琛,廖俊星,等.老年髋部骨折内固定失败后补救性髋关节置换术的临床研究[J].中华老年骨科与康复电子杂志,2016,(02):81.[doi:10.3877/cma.j.issn.2096-0263.2016.02.004]
 Li Mengyuan,Chen Hong,Ma Yuanchen,et al.Clinical research of hip arthroplasty as a salvage treatment after reduction and fixation failure in the proximal femoral fracture[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):81.[doi:10.3877/cma.j.issn.2096-0263.2016.02.004]
[13]赵德伟,马志杰,杨磊,等.多孔钽金属涂层髋关节假体置换治疗老年股骨颈骨折的临床疗效观察[J].中华老年骨科与康复电子杂志,2016,(02):92.[doi:10.3877/cma.j.issn.2096-0263.2016.02.006]
 Zhao Dewei,Ma Zhijie,Yang Lei,et al.Clinical investigation of hip implants by using porous tantalum coating in the treatment of elderly femoral neck fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):92.[doi:10.3877/cma.j.issn.2096-0263.2016.02.006]
[14]李玉龙,翁习生,董玉雷.老年全膝关节置换术围手术期并发症影响因素的研究进展[J].中华老年骨科与康复电子杂志,2016,(03):177.[doi:10.3877/cma.j.issn.2096-0263.2016.03.010]
 Li Yulong,Weng Xisheng,Dong Yulei.Research progress of influence factors concerning perioperative complications of total knee arthroplasty in aged patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):177.[doi:10.3877/cma.j.issn.2096-0263.2016.03.010]
[15]尹正录,孟兆祥,林舜艳,等.MOTOmed智能运动训练结合神经肌肉本体感觉促进技术对全膝关节置换术后功能恢复的影响[J].中华老年骨科与康复电子杂志,2017,(01):50.[doi:10.3877/cma.j.issn.2096-0263.2017.01.010]
 Yin Zhenglu,Meng Zhaoxiang,Lin Shunyan,et al.Effects of MOTOmed intelligent motor training and proprioceptive neuromuscular facilitation on postoperative function recovery in total knee arthroplasty[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(02):50.[doi:10.3877/cma.j.issn.2096-0263.2017.01.010]
[16]白伟侠,牛映祯,马红瑞,等.氨甲环酸在初次膝关节置换中的应用研究[J].中华老年骨科与康复电子杂志,2017,(06):362.[doi:10.3877/cma.j.issn.2096-0263.2017.06.009]
 Bai Weixia,Niu Yingzhen,Ma Hongrui,et al.Application of ammoniacal acid in primary total knee arthroplasty[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(02):362.[doi:10.3877/cma.j.issn.2096-0263.2017.06.009]
[17]黄子达,张子杰,李文波,等.多模式预防措施对老年关节置换术后静脉血栓栓塞症发生及转归的影响[J].中华老年骨科与康复电子杂志,2018,(02):80.[doi:10.3877/cma.j.issn.2096-0263.2018.02.004]
 Huang Zida,Zhang Zijie,Li Wenbo,et al.Incidence and outcome of postoperative venous thromboembolism in elderly patients underwent knee or hip arthroplasty with multimodal thromboprophylaxis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(02):80.[doi:10.3877/cma.j.issn.2096-0263.2018.02.004]
[18]白金,许可可,赵树华,等.老年人工全髋关节置换术后康复治疗的研究进展[J].中华老年骨科与康复电子杂志,2018,(02):125.[doi:10.3877/cma.j.issn.2096-0263.2018.02.011]
 Bai Jin,Xu Keke,Zhao Shuhua,et al.Review of rehabilitation after geriatric total hip arthroplasty[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(02):125.[doi:10.3877/cma.j.issn.2096-0263.2018.02.011]
[19]尹正录,金星,黄吉军,等.PNF技术在全膝关节置换术后患者功能恢复中的应用[J].中华老年骨科与康复电子杂志,2018,(04):219.[doi:10.3877/cma.j.issn.2096-0263.2018.04.006]
 Yin Zhenglu,Jin Xing,Huang Jijun,et al.Application of proprioceptive neuromuscular facilitation on postoperative function recovery in patients after total knee arthroplasty[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(02):219.[doi:10.3877/cma.j.issn.2096-0263.2018.04.006]
[20]朱琳华,张园园,陈晓青.葱白穴位贴敷联合艾灸预防人工关节置换术后尿潴留的效果观察[J].中华老年骨科与康复电子杂志,2018,(06):331.[doi:10.3877/cma.j.issn.2096-0263.2018.06.003]
 Zhu Linhua,Zhang Yuanyuan,Chen Xiaoqing.Observation on effect of acupoint sticking combined with Moxibustion on prevention of urinary retention after artificial joint replacement[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(02):331.[doi:10.3877/cma.j.issn.2096-0263.2018.06.003]

备注/Memo

备注/Memo:
基金项目:山东省重点研发计划(公益类专项)(2017GSF218065);山东省自然科学基金(ZR201702140118);济宁市科技发展计划(济科字[2015]57号-67)
更新日期/Last Update: 2019-04-12