摘要【目的】探讨胫骨平台后倾角(posterior tibial slope angle,PSA)变化对固定平台全膝关节置换术(posterior stabilized total knee arthroplasty,PS-TKA)术后疗效的影响。【方法】回顾性分析2016年6月至2019年6月在徐州医科大学附属医院初次行TKA的138例患者的临床资料,根据手术前后PSA的平均变化量分为A组(PSA变化≤6.4°,n=68)和B组(PSA变化＞6.4°,n=70)。术后随访1年,比较两组患者Blackburne-Peel指数(blackburne-peel ratio,BPR)、改良Insall-Salvati指数(modified insall-salvati ratio,mISR)、膝关节活动度(range of motion,ROM)及膝关节功能评分。【结果】两组聚乙烯垫片厚度比较,差异无统计学意义(P>0.05);A组关节遗忘评分(FJS)显著高于B组,差异有统计学意义(P<0.05);A组手术前后PSA变化值为(4.8±2.1)°,显著低于B组的(10.3±2.4)°,差异有统计学意义(P<0.05)。两组术后PSA、mISR、BPR、VAS评分、西安大略和麦克马斯特大学骨关节炎指数(the western ontario and mcmaster universities osteoarthritis index,WOMAC)评分显著低于术前(P<0.05);术后ROM、膝关节协会功能评分(american knee society score,KSS)临床评分、KSS功能评分显著高于术前(P<0.05)。A组术后PSA、ROM、KSS临床评分、KSS功能评分显著高于B组;A组术后VAS评分、WOMAC评分低于B组;但两组术后mISR评分、BPR评分比较,差异无统计学意义(P>0.05)。【结论】固定平台全膝关节置换术后患者PSA的变化越小,术后ROM越大,临床评分效果越好,术后疗效更显著。
Abstract：【Objective】To investigate the effect of changes in posterior tibial slope angle (PSA) on the postoperative efficacy of fixed platform total knee arthroplasty (PS-TKA).【Methods】A retrospective analysis was conducted on the clinical data of 138 patients who underwent TKA for the first time at the Xuzhou Medical University Affiliated Hospital from June 2016 to June 2019. According to the average change in PSA before and after surgery, they were divided into Group A (PSA change ≤ 6.4°,n=68) and Group B (PSA change>6.4°, n=70). After one year of postoperative follow-up, two groups of patients were compared in terms of Blackburn Peel Ratio (BPR), Modified Insell Salvati Ratio (mISR), Knee Range of Motion (ROM), and Knee Function Score.【Results】There was no statistically significant difference in the thickness of two sets of polyethylene gaskets (P>0.05); The joint forgetting score (FJS) of Group A was significantly higher than that of Group B, and the difference was statistically significant (P<0.05); The change in PSA before and after surgery in Group A was (4.8±2.1)°, significantly lower than that in the control group (10.3±2.4)°, and the difference was statistically significant (P<0.05). Postoperative PSA, mISR, BPR, VAS scores, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores of the two sets were significantly lower than preoperative (P<0.05); Postoperative ROM, American Knee Society score (KSS) Clinical Score and the KSS functional score were significantly higher than preoperative (P<0.05). Postoperative PSA, ROM, KSS clinical score and the KSS functional score in Group A were significantly higher than those of Group B; Postoperative VAS score and WOMAC score of Group A was lower than those of Group B; However, there was no statistically significant difference between the postoperative mISR score and BPR score between the two groups (P>0.05).【Conclusion】The smaller the change in tibial plateau tilt angle after fixed platform total knee arthroplasty, the greater the postoperative knee joint mobility, and the better the clinical scoring effect, which will bring better postoperative efficacy.
孙颢芸, 庞浩, 邵晨宇, 黄剑雄, 刘若茜, 何毅, 陈向阳, 吴居泰. 胫骨平台后倾角变化对固定平台膝关节置换术后疗效的影响*[J]. 医学临床研究, 2024, 41(5): 649-652.
SUN Haoyun, PANG Hao, SHAO Chenyu, et al. The Effect of Changes in Posterior Tibial Slope Angle on the Postoperative Efficacy of Fixed Platform Total Knee Arthroplasty. JOURNAL OF CLINICAL RESEARCH, 2024, 41(5): 649-652.
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2024, Vol. 41 
