不同设计理念的膝关节假体对初次人工全膝关节置换术后早期疗效的影响

Early effect of the primary total knee arthroplasty with different design concepts of knee prosthesis

摘要:

目的  从临床和功能角度回顾性分析比较不同设计理念膝关节假体在初次人工膝关节置换术后（TKA）的早期临床疗效，为临床提供参考。方法  选取2012年1月-2014年12月该院250例（250膝）膝骨关节炎的患者进行TKA术，男性70例，女性180例。本组手术病例膝关节假体的选择为Link Gemini MKⅡ，Smith-Nephew GenesisⅡ或Biomet Vanguard膝关节假体。采用美国膝关节协会评分系统（包括临床评分和功能评分）对本组病例进行随访，平均随访时间为1.5年（1～3年）。结果  本组病例共完成随访216例，随访率为86.4%。LINK Gemini MKⅡ，Smith-Nephew GenesisⅡ和Biomet Vanguard术后膝关节临床评分差异无统计学意义（P >0.05），而功能评分差异有统计学意义（P <0.05）。Smith-Nephew GenesisⅡ和Biomet Vanguard病例组的患者早期膝关节具有更好的功能。结论  3种膝关节假体在初次膝关节置换术中均能取得良好的手术疗效，但Smith-Nephew GenesisⅡ和Biomet Vanguard假体早期能更好的恢复术肢的膝关节功能。

Abstract:

Objective To compare the early effect of the primary total knee arthroplasty (TKA) with different design concepts of knee prosthesis. Methods From January 2012 to December 2014, a total of 250 patients (250 knees) with knee osteoarthritis (OA) was operated TKA, with 70 male and 180 female. The knee prosthesis of patients was one of LINK Gemini MK Ⅱ, Smith-Nephew Genesis Ⅱ and Biomet Vanguard. The American association of knee scoring system (including the clinical scores and function scores) was used to examine the surgical effect for the follow-up, and the average time of follow-up was 1.5 years (1 - 3 years). Results The total of 216 cases was completed the follow-up (86.4%). The knee clinical scores of LINK Gemini MK Ⅱ, Smith-Nephew Genesis Ⅱ and Biomet Vanguard postoperative had no significant difference (P > 0.05), and the functional scores had significant differences (P <0.05). The patients of Smith-Nephew Genesis II and Biomet Vanguard had better knee functions in the early follow-up. Conclusions All three kinds of knee prosthesis in the primary knee arthroplasty can provide good surgical effect on patients, and the prosthesis of Smith Nephew Genesis Ⅱ and Biomet Vanguard provide better restore function.