骨性膝關節炎的手術療法

Surgical Treatment of Osteoarthritic Knee

江振崑(Junn-Kuen Chiang) ； 林永福(Yeong-Fwu Lin)

《中華民國物理治療學會雜誌》 16卷1期 (1991/03) Pp. 25-36

https://doi.org/10.29616/JPTAROC.199103.0004

摘要

骨性膝關節炎的臨床表徵有三：(1)疼痛(2)關節內翻變形(3)活動障礙。當保守療法無效時必須訴諸手術治療，其目標就是要解除疼痛，矯正變形及改善行動能力。手術方法有許多種，依照每個病變的不同程度選擇最適當的手術法，以最小之組織破壞達到最大的療效，而且以保留原有的關節構造爲原則。高位脛骨截骨矯正術對早期的骨性關節炎有肯定的療效，但對於晚期之骨性膝關節炎患者所呈現出嚴重的變形，廣泛的關節面磨損，則須以人工關節置換術來治療；當膝關節有難以控制的細菌感染或人工關節造形術失敗後，剩留的骨質很差無法再重建時，才考慮關節固定術。

關鍵字

高位脛骨截骨矯正術 ； 全人工膝關節造形術 ； 骨性膝關節炎

並列摘要

Knee joint is the largest joint in our body. It is associated with weight bearing and performance of delicate motion. In the presence of osteoarthritis, pain and deformity disturb knee function. If conservative treatment failed, surgical procedures must be resorted to relieve pain, correct deformity and restore knee function. The main procedures used currently are high tibial osteotomy and total knee arthroplasty.
High tibial osteotomy has the advantages of simple procedure, preserving original structures and no limitation of activities after surgery. It is chosen for young active patients with early stage osteoarthritis confined to the medial compartment. Total knee arthroplasty has the effect of rapid pain relief and function recovery but it has the disadvantages of prosthetic loosening and limited activity. Currently used prostheses are of tricompartmental prosthesis with minimal constraint. Either cemented or porous-coated prosthesis has satisfactory result. The total condylar prosthesis has been used for more than 10 years and good results are still reported. The cementless, porous-coated prostheses are more prevalently used in the recent days. With the retaining of PCL, the cementless prostheses have better R.O.M. than that of total condylar prosthesis.

並列關鍵字

High Tibial Osteotomy ； Total Knee Arthroplasty ； Osteoarthritis of Knee