术前影像学测量对全膝关节置换术后HSS评分的影响

The Effect of Preoperative Imaging Measurement on HSS Score after Total Knee Replacement

摘要: 目的：研究全膝关节置换术股骨外翻角5˚、外旋角3˚截骨与术前影像学测量两角的实际值进行截骨，比较术后膝关节HSS评分差异。方法：分析2015年10月至2016年10月我院收治的100例膝骨关节炎患者。将其分为两组：常规截骨组与测量截骨组。测量组术前影像学测量股骨外旋角及股骨外翻角，以实测值截骨，常规组固定股骨外翻角5˚、外翻角3˚截骨，术后采用HSS评分标准，对相关数据进行统计学分析，比较两组的手术疗效。结果：两组HSS评分采用独立样本t检验方法(α = 0.05)，p = 0.002513 < 0.05，两组的HSS评分的差异有统计学意义，且测量组的评分整体高于常规组。结论：测量组较常规组术后膝关节功能恢复较好，术前影像学测量对TKA患者术后膝关节功能恢复有着重要的临床意义。

Abstract: Objective: To study the osteotomy of femoral valgus angle (5˚) and external rotation angle (3˚) in total knee arthroplasty (TKA) and to compare the difference of knee joint HSS score after oper-ation with the actual value of femoral varus angle and femur rotation angle measured by X-ray and CT before and after operation. To understand the clinical significance of preoperative im-aging measurement in the recovery of knee joint function after total knee arthroplasty. Methods: 100 patients with knee osteoarthritis treated in our hospital from October 2015 to October 2016 were analyzed. All the patients had no obvious history of trauma. The clinical examination confirmed osteoarthritis of knee joint by imaging examination and history, and all of them were varus genu. The non-technical causes such as postoperative infection, trauma and so on need to be revised. Severe systemic diseases and neuromuscular disorders affect activity, death, and failure to complete the assessment. The patients were divided into two groups: routine osteot-omy group (routine group) and measurement osteotomy group (measurement group). The external rotation angle of femur was measured by knee joint CT before operation in the measuring group. The femoral valgus angle was measured by X-ray film of the whole lower extremity, and osteotomy was performed according to the measured value. In the routine group, the femoral valgus angle was fixed at 5˚ and 3˚. The HSS score was used to analyze the relevant data statistically. Results: The HSS scores of the two groups were evaluated by independent sample t-test (α-0.05). The HSS score of the two groups was significantly higher than that of the control group (P < 0.05), and the HSS score of the two groups was significantly higher than that of the control group (P < 0.05). Conclusion: The knee joint function in the measurement group is better than that in the routine group, and the patients' degree of pain, walking function, extension and flex-ion activity, muscle strength, flexion deformity are better than that in the routine group. Preoperative measurement of femoral circumflex angle and femoral valgus angle has important clinical significance for the recovery of knee joint function after TKA.