残留轻度内翻不影响弓形股骨膝内翻膝关节置换的临床效果

李思宁; 王直兵; 程兴旺; 张峡

doi:10.16016/j.1000-5404.202105076

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残留轻度内翻不影响弓形股骨膝内翻膝关节置换的临床效果

临床医学 | 更新时间：2026-01-09

- 残留轻度内翻不影响弓形股骨膝内翻膝关节置换的临床效果
- Slight varus malalignment has no influence on clinical function in patients with femoral lateral bowing after total knee replacement
- 第三军医大学学报 2021年43卷第22期页码：2462-2467
- 作者机构：
  
  400037 重庆，陆军军医大学（第三军医大学）第二附属医院骨科
- 作者简介：
  
  [张峡，E-mail: zhangsw199254330@163.com ZHANG Xia, E-mail: zhangsw199254330@163.com
- 基金信息：
  
  重庆市技术创新与应用发展专项面上项目(cstc2019jscx-msxmX0261)
- DOI：10.16016/j.1000-5404.202105076
  中图分类号： R615;R684.2;R687.4
- 收稿：2021-05-18，
  
  修回：2021-07-12，
  
  纸质出版：2021-11-30
- 稿件说明：
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李思宁, 王直兵, 程兴旺, 等. 残留轻度内翻不影响弓形股骨膝内翻膝关节置换的临床效果[J]. 第三军医大学学报, 2021,43(22):2462-2467.

Sining LI, Zhibing WANG, Xingwang CHENG, et al. Slight varus malalignment has no influence on clinical function in patients with femoral lateral bowing after total knee replacement[J]. Journal of Third Military Medical University, 2021, 43(22): 2462-2467.
李思宁, 王直兵, 程兴旺, 等. 残留轻度内翻不影响弓形股骨膝内翻膝关节置换的临床效果[J]. 第三军医大学学报, 2021,43(22):2462-2467. DOI： 10.16016/j.1000-5404.202105076.

Sining LI, Zhibing WANG, Xingwang CHENG, et al. Slight varus malalignment has no influence on clinical function in patients with femoral lateral bowing after total knee replacement[J]. Journal of Third Military Medical University, 2021, 43(22): 2462-2467. DOI： 10.16016/j.1000-5404.202105076.

摘要

目的

探讨全膝关节置换(total knee arthroplasty

TKA)时，残留轻度下肢内翻对股骨外弓膝内翻患者功能的影响。

方法

采用回顾性队列研究设计，收集2015年1-12月在我科行TKA的152例下肢力线内翻的内侧膝骨关节炎(medial osteoarthritis of the knee

MOA)患者病例资料。根据术后的下肢力线将患者分为3组：轻度内翻(>3°~6°，A组)，重度内翻(>6°，B组)，中立位(-3°~3°，C组)。平均随访4.3年，比较各组间的国际膝关节协会(international knee society score

KSS)及麦克马斯特大学骨关节炎指数（Western Ontario and McMaster University Osteoarthritis Index，WOMAC）评分。

结果

随访期间，各组均无患者出现翻修。术后力线分别为A组术前（9.8±3.2）°，术后（4.3±0.6）°；B组术前（10.8±1.6）°，术后（7.1±1.2）°；C组术前（8.8±3.5）°，术后（0.6±1.3）°。术后各组KSS评分均有所提高，与C组[(157.0±29.4)分，

=0.02

]

及B组[(150.9±32.3)分，

=0.01

]

相比，A组总的KSS评分(167.5±26.1)提高更显著；功能评分上，与B组(

=0.04)及C组(

= 0.01)相比，A组的KSS评分提高更显著；膝关节评分上，A组较B组改善更明显(

=0.03)，但与C组相似。WOMAC评分上，与C组相比，A组具有更低的WOMAC总评分(

=0.02)、日常活动度（

=0.02）及僵硬度评分(

=0.03)；B组和C组具有相近的WOMAC评分。

结论

股骨外弓膝内翻患者行TKA时，残留轻度下肢内翻（>3°~6°）不影响术后的短期效果。

Abstract

Objective

To investigate the effect of residual slight varus malalignment after total knee arthroplasty (TKA) on the function in patients with femoral lateral bowing and medial osteoarthritis of the knee (MOA).

Methods

A retrospective cohort study was performed on 152 patients suffering from femoral lateral bowing and MOA and undergoing TKA in our hospital from January to December 2015. After a mean follow-up period of 4.3 years

the patients were stratified into mild varus (

3°~6°

group A

=45)

severe varus (

6°

group B

=26)

and neutral (-3°~3°

group C

=81) groups based upon their post-operative alignment. The International Knee Society Score (KSS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores were compared among the groups.

Results

No implant was revised during the follow-up period. The patients in the group A were averagely corrected from (9.8±3.2)° pre-operatively to (4.3±0.6)° post-operatively

those in the group B from (10.8±1.6)° to (7.1±1.2)°

and those in the group C from (8.8±3.5)° to (0.6±1.3)°. KSS scores were increased following TKA for all the groups. The group A scored significantly better in the total KSS score (167.5±26.1) as compared with the group C (157.0±29.4

=0.02) and group B (150.9±32.3

=0.01). In the functional sub-scores

a significantly better score was obtained in the group A when compared with the group B and group C (

=0.04

0.01). The knee sub-score of the group A was significantly better than those of the group B (

=0.03)

but was similar to that of the group C. With regard to the WOMAC score

the group A scored significantly lower than the group C in the total score (

=0.02) and in 2 of the sub-scores (Activities of daily living:

=0.02; stiffness:

=0.03). WOMAC scores were similar between the group B and C.

Conclusion

Our study indicates that mild varus malalignment (>3°~6°) didn't influence the effect of TKA for patients with femoral lateral bowing and MOA at the short-term follow-up period.

关键词

Keywords

references

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