内轴膝置换治疗膝骨关节炎的满意度分析及初步疗效

doi:10.3877/cma.j.issn.1674-134X.2019.04.018

中华关节外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (04) : 493 -497. doi: 10.3877/cma.j.issn.1674-134X.2019.04.018

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临床经验

内轴膝置换治疗膝骨关节炎的满意度分析及初步疗效

陈雪燕¹, 李振兴¹, 李莉², 陈成旺², 薛恩兴², 郑文娴¹, 张宇¹, 樊沛¹^,^†(

)

^1. 325027　温州医科大学附属第二医院、育英儿童医院骨科；325027　温州，浙江省骨科学重点实验室
^2. 325027　温州医科大学附属第二医院、育英儿童医院麻醉科；325027　温州，浙江省麻醉学重点实验室

收稿日期:2018-11-02 出版日期:2019-08-01
通信作者: 樊沛
基金资助:
温州市科技局项目(Y20180029)

Satisfaction and short-term clinical outcome of total knee arthroplsty using medial pivot knee for knee osteoarthritis

Xueyani Chen¹, Zhenxing Li¹, Li Li², Chengwang Chen², Enxin Xue², Wenxian Zheng¹, Yu Zhang¹, Pei Fan¹^,^†()

^1. Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou 325027, Chin
^2. Department of Anesthesia, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China; Zhejiang Provincial Key Laboratory of Anesthesia, Wenzhou 325027, China.

Received:2018-11-02 Published:2019-08-01
Corresponding author: Pei Fan
About author:
Corresponding author: Fan Pei, Email: fanpei@wmu.edu.cn

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陈雪燕, 李振兴, 李莉, 陈成旺, 薛恩兴, 郑文娴, 张宇, 樊沛. 内轴膝置换治疗膝骨关节炎的满意度分析及初步疗效[J/OL]. 中华关节外科杂志(电子版), 2019, 13(04): 493-497.

Xueyani Chen, Zhenxing Li, Li Li, Chengwang Chen, Enxin Xue, Wenxian Zheng, Yu Zhang, Pei Fan. Satisfaction and short-term clinical outcome of total knee arthroplsty using medial pivot knee for knee osteoarthritis[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2019, 13(04): 493-497.

分析内轴膝假体置换术后疗效，评估患者满意度。

方法

对温州医科大学附属第二医院关节外科单一术者2016年8月至2017年10月期间使用内轴膝假体进行膝关节置换的患者进行至少1年随访，对患者的满意度及不满意原因进行调查和分析，并调查患者膝关节疼痛程度及关节活动度。

结果

52例患者纳入此研究，手术时平均年龄(73±6)岁，随访时间(13.9±1.4)个月。内轴膝假体总体满意度达到90.38%，其中不满意的原因最主要是持续性膝关节疼痛，内轴膝假体置换后患者疼痛数字评分中位数M为0，四分位数间距为0，膝关节活动度为(93±12)°。

结论

内轴膝置换治疗终末期膝骨性关节炎疗效确切，患者满意度高，术后膝关节持续性疼痛仍然是患者不满意最主要的原因。

关键词: 关节成形术，置换，膝, 病人满意度, 假体和植入物

Objective

To investigate clinical outcome of medial pivot(MP) knee prosthesis, the satisfaction rate and the causes of the dissatisfaction.

Methods

A survey was used for collecting information from patients undergoing primary total knee arthroplasty (TKA) using MP prosthesis from August 2016 to October 2017. The minimum follow-up time was at least one year. The satisfaction and the causes of dissatisfaction were analyzed while the pain numeric rating scales(NRS) and range of motion were investigated.

Results

Fifty-two patients performed TKA using this prosthesis were enrolled in this study, the average age was (73±6) years and the average follow-up time was (13.9±1.4)months. The satisfaction rate of MP prosthesis reached 90.38%. The most common cause of dissatisfaction was persistent pain around knee. The median of NRS score was 0, the inter-quartile range was 0. The range of motion was(93±12)°.

Conclusion

TKA using MP prosthesis achieves clinical good results and has a high satisfaction rate, yet persistent pain around knee after TKA is still the most common reason for dissatisfaction.

Key words: Arthroplasty, replacement, knee, Patient satisfaction, Prostheses and implants

图1 上海微创公司的内轴膝垫片。图中可见内轴膝垫片为内侧为轴，前缘垫高的设计，图A为面观；图B为内侧面观

图2 右侧内轴膝关节置换手术前后X线片。膝关节无明显疼痛，膝关节活动度0°～110°。图A为右膝术前正侧位片，示右侧膝关节骨关节炎；图B为双下肢术前全长片；图C为右膝术后正侧位片，示膝关节活动良好；图D为双下肢术后全长片

图3 内轴膝置换术后NRS评分(疼痛数字评分)情况

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