经股内侧肌入路降低全膝关节置换术术后不良反应及促进膝关节功能康复

为评估髌骨旁内侧入路和经股内侧肌入路两种手术技术在全膝关节置换术(total knee arthroplasty,TKA)中的早期功能结果,本研究选取50例2013年3月至2017年3月期间在我院行全膝关节置换数的患者作为研究对象,随机分为两组。一组患者通过髌骨旁内侧入路进行TKA手术,另外一组患者通过经股内侧肌入路方法进行TKA手术。所有患者均只进行一次手术,两组均使用相同类型的植入物。使用视觉模拟评分法(visual analogue scale, VAS)记录疼痛评分,并在术后3周和6周时获得随访数据,包括股四头肌强度和本体感受。结果表明,TKA术后,经股内侧肌入路组患者在休息和运动时表现出明显较低的疼痛(VAS:平均2.13±1.87与2.84±1.76)和(VAS:平均3.11±2.16与3.21±2.02)。此外,经股内侧肌入路组患者在3周((41.2±17.8) Nm vs (27.3±14.1) Nm)和6周((47.4±19.5) Nm vs (35.6±16.2) Nm)显示出优异的等长股四头肌强度。另外,经股内侧肌入路组患者术后本体感觉良好,而两组患者的运动范围相似。研究初步表明,在早期康复期间,经股内侧肌入路方法比髌骨旁内侧入路更有优势。没有观察到与此方法相关的不良影响。因此,经股内侧肌入路应被认为是TKA中有价值的替代方法。

Midvastus Approach Reduces Adverse Reactions after Total Knee Arthroplasty and Promotes Knee Function Recovery

Early functional outcomes in total knee arthroplasty for the evaluation of the medial parapatellar approach and the midvastus approach. In this study, 50 patients who underwent total knee arthroplasty in our hospital from March 2013 to March 2017 were randomly divided into two groups. One group of patients underwent TKA surgery through the medial parapatellar approachs, and another group of patients underwent TKA surgery via the midvastus approach. All patients underwent only one operation, and both groups used the same type of implant. Pain scores were recorded using a visual analogue scale(VAS) and follow-up data were obtained at 3 and 6 weeks postoperatively, including quadriceps strength and proprioception. The results showed that after TKA, patients in the midvastus approach showed significantly lower pain during rest and exercise(VAS: mean2.13±1.87 and 2.84±1.76) and(VAS: mean 3.11±2.16 and 3.21±2.02). In addition, patients in the midvastus approach showed excellent isometric quadriceps strength at 3 weeks((41.2±17.8) vs(27.3±14.1) Nm) and 6 weeks((47.4±19.5) Nm vs(35.6±16.2) Nm). In addition, patients in the midvastus approach group had a good postoperative proprioception, while the motion range of the two groups was similar. Studies have shown that during the early recovery, the midvastus approach is more advantageous than the medial parapatellar approach. No adverse effects associated with this method were observed. Therefore, the midvastus approach should be considered a valuable alternative to TKA.