Total Knee Arthroplasty after Failed Dome Osteotomy

以人工關節置換治療半球型切骨術失敗患者之探討

黃炫迪(H.T Huang) ； 蘇景源(J.Y. Su) ； 蘇凱南(K.N. Su) ； 田英俊(Y.C. Tien)

《The Kaohsiung Journal of Medical Sciences》 18卷10期 (2002/10) Pp. 485-491

https://doi.org/10.6452/KJMS.200210.0485

摘要

本研究為比較１７位膝關節患者中，１５位使用半球型切骨術治療失敗後以人工關節置換治療（研究組）與１４位患者直接以人工關節置換治療（控制組），在臨床上和Ｘ光分析之差異。研究組平均追蹤時間為５９.４個月（２５－１４６月），控制組為62.3個月（４３－１４０月）。依據美國膝關節協會評分等級，結果發現研究組９４％有良好或好的結果。研究組與控制組於術後膝關節評分、功能評分與關節彎曲角度並無顯著差異。雖有２例矯正後過外翻與１例嚴重內翻的病例於人工關節置換中須以自體骨骼填補脛骨部位骨骼缺失。一般而言，半球型切骨術後並不會危害再進行人工關節置換。

關鍵字

人工關節置換；半球型切骨術

並列摘要

A retrospective, clinical and radiographic analysis was done between a study group of 15 patients with 17 total knee arthroplasties done following failed, proximal-tibial dome osteotomies and a control group of 14 patients with 17 primary arthroplasties. The groups were matched according to age of patients, type of prosthesis, primary disease and length of follow-up. The average length of follow-up was 59.4 months (range, 25-146 mo) in the study group and 62.3 months (range, 43-140 mo) in the control group. On the basis of the knee rating scale of the American Knee Society, 94% of the patients had either an excellent or a good result in the study group. There were no significant differences in knee scores, function scores, or range of motion of the knee between the two groups during the follow up period. Although two overcorrected valgus knees and one severe varus knee necessitated m autogeneic bone graft for tibial defects at the time of implantation of the secondary prosthesis, dome osteotomy does not appear to compromise a subsequent arthroplasty.

並列關鍵字

total knee arthroplasty；arthritis；failed high tibial osteotomy