目的 探究单髁膝关节置换（UKA）联合注射布比卡因脂质体治疗老年孤立性内侧间室骨关节炎（OA）的效果，并分析其对患者术后长效镇痛的作用。方法 前瞻性选取2023年11月—2025年11月期间收治的80例老年孤立性内侧间室OA患者，分为对照组与研究组，各40例。两组患者均接受UKA手术治疗，研究组在术中于相同部位注射布比卡因脂质体，对照组于术中关节周围注射等体积的生理盐水混合物。比较两组术后疼痛强度，镇痛药物消耗与需求，早期膝关节功能恢复情况、早期膝关节功能，以及两组不良反应发生率。结果 研究组术后6 h、12 h、24 h及48 h VAS评分均低于对照组，术后48 h内，研究组中重度疼痛发生率较对照组低（P＜0.05）；研究组术后首次请求镇痛的时间晚于对照组，48 h内曲马多总消耗量及补救镇痛需求率均较对照组低（P＜0.05）；研究组在术后24 h、48 h、72 h的膝关节主动活动度较对照组大，研究组首次直腿抬高时间、术后下地行走时间及住院时间均较对照组短（P＜0.05）；术前两组膝关节协会评分（KSS）和牛津膝关节评分（OKS）评分无差异（P＞0.05）。术后1周，两组评分均改善，且研究组优于对照组（P＜0.05）；两组不良反应发生率无差异（P＞0.05）。结论 UKA术中联合应用布比卡因脂质体，能安全、有效地为老年孤立性内侧间室OA患者提供长效术后镇痛。且该方案不仅能显著减轻患者早期疼痛、减少阿片类药物依赖，更能有效促进膝关节早期功能恢复、缩短住院时间，并为患者获得更优的早膝关节功能奠定基础。

    Objective To investigate the efficacy of unicompartmental knee arthroplasty（UKA） combined with injection of bupivacaine liposomes in the treatment of elderly isolated medial compartment osteoarthritis（OA），and analyze its long-term analgesic effect on patients after surgery．Methods A prospective study was conducted on 80 elderly patients with isolated medial compartment OA admitted between November 2023 and November 2025．They were divided into a control group and a study group，with 40 patients in each group．Both groups of patients received UKA treatment．The study group received injection of bupivacaine liposomes at the same site during surgery，while the control group received injection of an equal volume of physiological saline mixture around the joints during surgery．Postoperative pain intensity，analgesic drug consumption and demand，early knee joint function recovery，early knee joint function were compared between two groups，and the incidence of adverse reactions was compared between the two groups．Results The study group had lower VAS scores at 6 h，12 h，24 h，and 48 h postoperatively compared to the control group．Within 48 hours after surgery，the incidence of moderate to severe pain in the study group was lower than that in the control group（P＜0.05）．The time to first postoperative analgesic request in the study group was later than that in the control group，and the total tramadol consumption and the need for analgesia within 48 hours were lower（P＜0.05）．The active range of motion of the knee at 24 h，48 h，and 72 h postoperatively was greater in the study group compared to the control group．Additionally，the time to first straight leg raise，time to ambulation，and length of hospital stay were all shorter in the study group（P＜0.05）．Preoperatively，there were no differences between the two groups in the Knee Society Score（KSS） and the Oxford Knee Score（OKS）（P＞0.05）．One week postoperatively，both groups showed improved scores，with the study group showing greater improvement than the control group（P＜0.05）．There was no significant difference in the incidence of adverse reactions between the two groups（P＞0.05）．Conclusions The combined use of bupivacaine liposomes during UKA can provide safe and effective long-term postoperative analgesia for elderly patients with isolated medial compartment OA．And this plan not only reduces early pain and opioid dependence in patients，but also effectively promotes early knee joint function recovery，shortens hospitalization time，and lays a solid foundation for patients to achieve better early knee joint function．

全膝关节置换术（TKA）是目前治疗终末期膝关节疾病的首选方法,它能够缓解疼痛、改善畸形、恢复力线、增加膝关节活动度及提高患者生活质量。目前,关于胫骨假体旋转对线的方法很多,主要包括胫骨结节、胫骨前后轴、胫骨前皮质、自我形合技术、计算机辅助导航技术、个性化截骨技术等,它们各有优缺点,但在临床上并没有达成共识。该文主要对胫骨近端的解剖学特点和TKA中胫骨假体旋转定位的方法等方面进行综述。旨在为临床骨科医生在行TKA时,选择合适的胫骨假体旋转对线方法提供一些参考。

Total knee replacement（TKA） is currently the preferred treatment for end-stage knee disease,and it can relieve pain,improve deformity,restore strength lines,increase knee range of motion,and improve patients’ quality of life．At present,there are many methods for the rotation of alignment of tibial prosthesis,mainly including tibial tubercles,tibial anteroposterior axes,anterior tibial cortex,self-morphing technology,computer-aided navigation technology,personalized osteotomy technology,etc．Each of the methods above has its advantages and disadvantages,but there is no clinical consensus at present．This article mainly reviews the anatomical characteristics of the proximal tibia and the method of rotational positioning of tibial prosthesis in TKA,which aims to provide some reference for clinical orthopedic surgeons to select the appropriate tibial prosthesis rotation alignment method when performing TKA．

目的 探讨富血小板血浆（PRP）联合关节镜治疗Ⅲ度半月板损伤患者的临床疗效,及其对膝关节功能恢复时间的影响。方法 选取2021年2月—2022年2月南方医科大学南方医院增城院区骨科收治的Ⅲ度半月板损伤患者45例,采用随机数字法分为观察组22例与对照组23例,对照组患者在关节镜下行半月板成形术,观察组在对照组基础上给予PRP治疗。观察两组患者术后恢复时间、治疗效果及并发症发生情况;比较两组治疗前和治疗后1、3、6个月膝关节功能、疼痛情况。结果 利用观察组患者自体全血制备的PRP,其血小板的回收率、红细胞留存率、白细胞留存率分别为（91.00±9.27）%、（0.29±0.12）%、（29.98±6.68）%,PRP制备质量稳定、可控。观察组联合PRP治疗术与关节镜手术治疗后恢复时间均短于对照组,观察组治疗有效率高于对照组（P<0.05）。经重复方差测量分析,两组美国特种外科医院膝关节评分系统（HSS）评分、西安大略大学和麦克马斯特大学骨关节炎指数（WOMAC）评分、视觉模拟疼痛评分法（VAS）交互（F_交互=1.869、F_交互=1.482、F_交互=2.193）比较差异均有统计学意义（P<0.05）;与对照组治疗后1、3、6个月比较,观察组HSS评分升高,WOMAC评分、VAS评分下降（P<0.05）;观察组并发症总发生率4.55%低于对照组30.43%（χ²=5.156、P=0.023）。结论 对于Ⅲ度半月板损伤患者,采用PRP联合关节镜手术治疗可帮助患者消炎止痛、加快疗效、加快膝关节功能的恢复,缩短其恢复的时间,效果良好,且安全性较高。

Objective To investigate the clinical effect of platelet rich plasma（PRP）combined with arthroscopy treatment on patients with third degree meniscus injury,and its impact on the recovery time of knee joint function．Methods From February 2021 to February 2022,45 patients with III-degree meniscal injuries admitted to the Department of Orthopedics,Zengcheng district,Nanfang Hospital of Southern Medical University were selected and divided into an observation group of 22 cases and a control group of 23 cases using the random number method．Patients in the control group received menisplasty under arthroscopy,and the observation group was given PRP treatment on the basis of the control group．The postoperative recovery time,treatment effects and complications of the two groups of patients were observed;the knee joint function and pain of the two groups before treatment and 1,3,and 6 months after treatment were compared．Results The platelet recovery rate,red blood cell retention rate,and white blood cell retention rate of PRP prepared from the autologous whole blood of patients in the observation group were（91.00±9.27）%,（0.29±0.12）%,and（29.98±6.68）% respectively．The PRP preparation quality is stable and controllable．The recovery time after combined PRP treatment and arthroscopic surgery in the observation group was shorter than that in the control group,and the treatment effectiveness of the observation group was higher than that of the control group（P<0.05）．After repeated measures of variance analysis,the comparison of American Hospital for Special Surgery（HSS）Knee Scoring System,Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）,and visual analogue pain scales（VAS）interacted(F_Interaction=1.869,F_interaction=1.482,F_interaction=2.193),the differences were statistically significant（P<0.05）．Compared with the control group 1,3,and 6 months after treatment,the HSS score of the observation group increased,and the WOMAC score,VAS score decreased（P<0.05）;the total incidence of complications in the observation group was 4.55%,lower than that in the control group（30.43%,χ²=5.156,P=0.023）．Conclusions For patients with III-degree meniscal injuries,PRP combined with arthroscopic surgery can help reduce inflammation and pain,speed up the curative effect,accelerate the recovery of knee joint function,and shorten the recovery time．It has good effects and is relatively safe．

目的 探讨本体感觉训练联合等速肌力训练对早期膝骨关节炎（KOA）患者的应用效果。方法 选择郑州市骨科医院2022年5月—2023年5月收治的120例早期膝骨关节炎患者为研究对象,将所有对象进行编号,采用简单随机方法分成研究组和对照组,每组各60例,两组均接受常规治疗,对照组在此基础上接受等速肌力训练,研究组在对照组基础上联合应用本体感觉训练,比较两组治疗前和治疗6周后疼痛视觉模拟量表（VAS）评分、膝关节伸屈肌群峰力矩（PT）、关节功能以及本体感觉。结果 治疗后研究组VAS评分为（1.33±0.31）分,对照组为（2.05±0.34）分,研究组低于对照组（t=12.121,P<0.05）;治疗后两组膝关节伸、屈肌群PT均较治疗前明显增加（P<0.05）,研究组大于对照组（t₁=2.696,t₂=3.360,P<0.05）;治疗后研究组WOMAC评分为（24.58±5.14）分,对照组为（26.85±5.11）分,研究组低于对照组（t=2.426,P<0.001）,研究组Lequesne指数为（6.55±1.21）分,对照组为（7.02±1.25）分,研究组低于对照组（t=2.093,P<0.001）;治疗后研究组平均轨迹误差为（21.35±5.96）%,对照组为（24.06±5.88）%,研究组改善程度优于对照组（t=2.507,P<0.001）,研究组平均负重力量差为（0.77±0.22）kg,对照组为（1.01±0.24）kg,研究组改善程度明显优于对照组（t=5.710,P<0.001）。结论 本体感觉训练联合等速肌力训练可以显著提升早期膝骨关节炎患者肌力,改善关节功能和本体感觉作用明显,适合推广。

Objective To explore the application effect of proprioceptive training combined with isokinetic muscle strength training on early knee osteoarthritis（KOA）patients．Methods A total of 120 patients with early knee osteoarthritis admitted to a hospital from May 2022 to May 2023 were selected as the study subjects．All subjects were numbered and randomly divided into an experimental group and a control group,with 60 cases in each group．Both groups received routine treatment,while the control group received isokinetic muscle strength training additionally．The experimental group received proprioceptive training in addition to the control group treatment．After 6 weeks of treatment,compare the pain situation,peak torque（PT）of knee extensor and flexor muscles,joint function,and proprioception before and after treatment between two groups were compared．Results After treatment,the VAS scores of both groups were lower than those before treatment（P<0.05）,and the experimental group was lower than the control group（t=12.121,P<0.05）．After treatment,the PT of the knee joint extensor and flexor muscle groups in both groups significantly increased compared to before treatment（P<0.05）,and the experimental group was significantly larger than the control group（P<0.05）．After treatment,the WOMAC score and Lequesne index of the two groups significantly decreased compared to those before treatment（P<0.05）,and the experimental group was smaller than the control group（P<0.05）．After treatment,the average trajectory error and average weight difference between the two groups were significantly smaller than those before treatment（P<0.05）,while the experimental group was smaller than the control group（P<0.05）．Conclusion sThe combination of proprioceptive training and isokinetic muscle strength training can significantly improve muscle strength,joint function,and proprioceptive sensation in patients with early knee osteoarthritis,making it suitable for promotion．

目的 探讨透明质酸钠注射联合富含血小板的血浆治疗膝骨关节炎患者的效果。方法 收集2019年7月—2021年7月在本院就诊的膝骨关节炎患者120例,采用随机数字表法分组,即对照组、观察组,均60例。对照组患者注入富含血小板的血浆(4 mL),观察组患者注射透明质酸钠(2 mL)联合富含血小板的血浆(3.5 mL),1次/周,3次为1个疗程,共2～3疗程。统计2组患者膝关节功能、临床疗效及并发症发生率。结果 ①组内比较:治疗后2月、3月及6月平均Lysholm膝关节评分均升高,P<0.05;②组间比较:治疗前及治疗后2月,2组患者平均Lysholm膝关节评分比较,P>0.05,治疗后3月、6月,2组平均Lysholm膝关节评分比较,P<0.05。2组患者Lysholm膝关节评分均较治疗前有所改善,P<0.05;观察组疼痛评分(18.92±4.11、17.61±3.83)分、肿胀度评分(10.64±2.82、9.66±1.21)分均高于对照组疼痛评分(14.02±3.52、13.54±3.21)分、肿胀度评分(9.62±2.63、8.71±1.93)分(P<0.05)。观察组临床总有效率98.33%高于对照组临床总有效率88.33%(χ²=4.821,P=0.028)。经过6个月的随访后,2组均1例出现局部肿胀,未发生其他并发症。结论 透明质酸钠注射联合富含血小板的血浆治疗膝骨关节炎患者,可以有效改善患者膝关节功能,减轻患者疼痛及肿胀程度等,安全性高,值得推广应用。

Objective To investigate the effect of sodium hyaluronate injection combined with platelet-rich plasma in the treatment of patients with knee osteoarthritis. Methods A total of 120 patients with knee osteoarthritis who were treated in our hospital from July 2019 to July 2021 were collected and randomly divided into control group and observation group,60 cases each.The patients in the control group were injected with platelet-rich plasma(4 mL),and the patients in the observation group were injected with sodium hyaluronate(2 mL)combined with platelet-rich plasma(3.5 mL),once a week,3 times as a course of treatment,total 2-3 courses of treatment.The knee joint function,clinical efficacy and complication rates of the two groups were compared. Results ①Intra-group comparison:the average Lysholm knee joint scores were significantly increased in 2 months,3 months and 6 months after treatment,P<0.05. ②Comparison between groups:before and 2 months after treatment,the average Lysholm knee joint scores of the two groups were significantly increased (P<0.05). After 3 months and 6 months treatment,the comparison of the average Lysholm knee score between the two groups were statistic significant (P<0.05).The Lysholm knee joint scores in both groups were improved compared with those before treatment (P<0.05). Three months after treatment,the pain score(18.92±4.11, 17.61±3.83)and swelling score(10.64±2.82, 9.66±1.21)in the observation group were significantly higher than those in the control group(14.02±3.52, 13.54±3.21, 9.62±2.63, 8.71±1.93, P<0.05).The total clinical effective rate of the observation group was 98.33%,which was significantly higher than that of the control group (88.33%, χ²=4.821,P=0.028).After 6-month follow-up,local swelling occurred in 1 case in both groups,and no other complications occurred. Conclusions Sodium hyaluronate injection combined with platelet-rich plasma in the treatment of patients with knee osteoarthritis can effectively improve the knee joint function and reduce the pain and swelling of the patients.It is safe and worthy of popularization and application.

目的 探讨磁共振成像（MRI）技术在膝关节隐匿性骨折临床诊断中的应用价值。方法 从我院2020年7月—2022年7月期间接诊的膝关节隐匿性骨折病例中随机抽取78例作为研究对象,所有病例均开展MRI、CT检查,分析并比较MRI和CT检查对该病变的检出率。结果 在78例膝关节隐匿性骨折病例中,MRI检查确诊76例,检出率97.44%,CT检查确诊61例,检出率78.21%,MRI检查对该疾病的检出率相比CT检查更高,差异有统计学意义（P<0.05）。MRI对半月板损伤、关节腔少量积液、韧带损伤、骨折塌陷及水平错位检出率相比CT更高,差异有统计学意义（P<0.05）,两种检查方式在严重骨折检出率差异较小,差异无统计学意义（P>0.05）。结论 在膝关节隐匿性骨折的临床诊断中应用MRI对疾病检出率较高,且操作简便,在临床中具有较高的推广价值。

Objective To investigate the application value of magnetic resonance imaging(MRI)in the clinical diagnosis of occult knee fractures. Methods A total of 78 cases of occult knee fracture received by our hospital from July 2020 to July 2022 were randomly selected as research subjects,and MRI and CT examinations were performed on all cases,and the detection rates of MRI and CT examination were analyzed and compared. Results Among the 78 cases of occult knee fracture,76 cases were confirmed by MRI examination,with a detection rate of 97. 44%,and 61 cases by CT examination,with a detection rate of 78. 21%,and the detection rate of MRI examination for this disease was higher than that of CT examination,and the difference was statistically significant(P<0. 05). MRI had higher detection rate of meniscal injury,small effusion in the joint cavity,ligament injury,fracture collapse and horizontal misalignment than CT(P<0. 05),and the difference in the detection rate of severe fractures was small and not statistically significant(P>0. 05). Conclusions The application of MRI in the clinical diagnosis of occult knee fracture has a high disease detection rate and simple operation,and has high promotion value in clinical practice.

目的 探讨富血小板血浆(platelet-rich plasma, PRP)联合髓芯减压治疗早期膝关节自发性骨坏死(spontaneous osteonecrosis of the knee, SONK)的临床疗效。方法 回顾性分析我院2015年6月—2020年6月收治Koshino分期为Ⅰ、Ⅱ期的SONK患者,按治疗方法不同分为单纯髓芯减压组(对照组 21例)和PRP注射+髓芯减压组(PRP组 22例),比较2组患者治疗前、后1月、3月、6月、12月的VAS评分、WOMAC评分,评估术前和随访时膝关节功能,并观察记录有无并发症。结果 43例患者术后随访12～62个月,2组患者治疗后均无切口感染、关节感染、深静脉血栓等并发症。2组患者术前VAS评分、WOMAC评分比较无统计学意义(P>0.05);VAS评分、WOMAC评分在术后1、3、6 、12月较术前比较差异均有统计学意义(P<0.05);与对照组相比,PRP组术后3、6、12月的VAS评分降低(P＜0.05),PRP组在术后6、12月的WOMAC评分改善(P＜0.05)。PRP组、对照组的总体有效率分别为90.48%(19/21)、77.27%(17/22),差异有统计学意义(P＜0.05)。在完成治疗12个月后至今的随访中,对照组共有6例患者、PRP组仅2例患者行单髁置换。结论 富血小板血浆联合髓芯减压治疗早期SONK,安全有效,临床疗效优于单纯髓芯减压术。

Objective To investigate the clinical effect of platelet-rich plasma(PRP) combined with core decompression in the treatment of early spontaneous osteonecrosis of the knee(SONK). Methods A retrospective analysis of SONK patients with Koshino stage I and Ⅱ admitted to our hospital from June 2015 to June 2020 was carried out. According to the different treatment methods, patients were divided into core decompression group (control group, 21 patients), and knee joint cavity PRP injection combined with core decompression group (PRP group, 22 patients). The VAS scores and WOMAC scores before treatment, 1, 3, 6 and 12 months after surgery were compared between the two groups to assess the knee joint function, and observed whether there were complications. Results Forty-three patients were followed up for 12 to 62 months after the operation. After treatment, the two groups had no complications such as wound infection, joint infection, or deep vein thrombosis. The preoperative VAS score and WOMAC score of the two groups were not significantly different (P>0.05);compared with those before the operation, VAS score and WOMAC score were significantly different at 1, 3, 6, and 12 months after the operation (P<0.05); compared with the control group, the VAS score of the PRP group was significantly reduced at 3, 6, and 12 months after surgery (P<0.05), and the WOMAC score of the PRP group was significantly improved at 6 and 12 months after surgery (P<0.05). The overall effective rates of the PRP group and the control group were 90.48% (19/21) and 77.27% (17/22) respectively, and the difference between the two groups was statistically significant (P<0.05). In the follow-up 12 months after the completion of the treatment, 6 patients in the control group and 2 patients in the PRP group underwent unicondylar replacement. Conclusion The combination of platelet-rich plasma and core decompression in the treatment of early SONK was safe and effective, and the clinical effect was better than that of core decompression only.

目的 探索在全膝关节置换(TKA)围手术期中实施以中医透药+整体针疗法为特色的中西医结合加速康复方案的可行性,考察中医、西医加速康复措施在单独应用和联合应用时的促康复效能。方法 以在我院行首次单侧全膝关节置换术的患者为研究对象。根据围手术期干预差异分为四组:A组12例,根据指南采取传统常规的围手术期处理;B组12例,在A组基础上,采取了西医加速康复措施;C组14例,在A组基础上,采取了中医透药+整体针疗法;D组15例,兼采用西医加速康复措施和中医透药+整体针疗法。统计所有患者术后24小时、术后3天视觉模拟疼痛评分(VAS)和术前、术后2周膝关节功能评分(HSS)。并作以上数据的组间比较。结果 四组患者术后24 h VAS组间差异无统计学意义,术后3 d VAS组间总体差异有统计学意义:组间两两比较,B、C、D组均低于A组(P<0.05),B、C、D组间差异则无统计学意义。四组患者术前HSS组间差异无统计学意义,术后2周HSS组间总体差异有统计学意义:组间两两比较,B、C、D组均高于A组(P<0.05),A、B、C组均低于D组(P<0.05),B、C组间差异无统计学意义。结论 中医透药+整体针疗法在TKA围术期应用切实可行,与加速康复理念有机结合可有效缓解患者围术期疼痛,改善术后膝关节功能。

Objective To explore the feasibility of implementing the accelerated rehabilitation program of integrated traditional Chinese and western medicine featuring TCM and holistic acupuncture in the perioperative period of total knee arthroplasty (TKA),and investigate the effectiveness of accelerated rehabilitation under concept of recovery after surgery ERAS of traditional Chinese medicine and western medicine in single application and joint application. Methods The patients who underwent the first unilateral total knee arthroplasty in our hospital were studied. According to the interventions during the perioperative period, they were divided into 4 groups: 12 cases in group A, which were treated according to the guidelines and traditional perioperative treatment; 12 cases in group B, on the basis of group A, western medicine accelerated rehabilitation measures were taken; for the 14 case in group C, on the basis of group A, TCM penetration combinate with holistic acupuncture therapy was adopted; in group D, the combination of western medicine accelerated rehabilitation measures and the TCM therapy above were implemented in 15 cases. The visual analogue score (VAS)of all patients at 24 hours and 3 days after surgery were counted, and their knee function scores in hospital for special surgery (HSS scores) were recorded before and 2 weeks after the surgery. Comparisons of the data above between different groups were carried out. Results There was no statistically significant difference between the 4 groups in the VAS at 24 h after the operation, but statistically significant difference was found in the comparison of VAS at the 3rd day after the operation;In pairwise comparison, the 3rd day's VAS of group B, C and D were all lower than that of group A (P<0.05). There was no statistically significant difference between the 4 groups in the HSS score before the operation, but statistically significant difference was found in the comparison of HSS score at the 2nd week after the operation;In pairwise comparison, the 2nd week's HSSscore of group B, C and D were all higher than group A (P<0.05),and that of group A,B and C were all lower than that of group D (P<0.05). Conclusion The application of TCM penetration medicine combinated with holistic acupuncture in perioperative period of TKA is practical and feasible. The combination of western medicine accelerated rehabilitation measures and the TCM therapy can effectively relieve patients' perioperative pain and improve postoperative knee function.

目的 研究我院自拟肿痛消方中药离子导入联合关节镜手术治疗膝骨性关节炎的疗效。方法 将76 例膝骨性关节炎患者分为2组,即肿痛消方离子导入联合关节镜组和单纯关节镜组,在治疗前、后分别对两组患者进行Lysholm膝关节功能评分。结果 肿痛消方联合关节镜手术治疗对膝骨性关节炎的治疗效果有明显的提高,总有效率达到92.11%,高于对照组。结论 肿痛消方联合关节镜手术治疗对膝骨性关节炎具有良好的治疗效果。可明显降低患者的疼痛感,改善膝关节功能,促进骨关节的恢复。

Objective To study the effect of Zhongtongxiao formula combined with arthroscopy in the treatment of knee osteoarthritis. Methods 76 patients with knee osteoarthritis were divided into two groups, namely, the group of Zhongtongxiao square ion-implantation combined with arthroscopy and the group of arthroscopy alone. Lysholm knee function scores were performed on the two groups before and after treatment. Results The therapeutic effects of Zhongtongxiao formula combined with arthroscopic surgery on knee osteoarthritis were improved, the total effective rate was 92.11%, higher than the control group. Conclusion Zhongtongxiao formula combined with arthroscopy has good therapeutic effect on knee osteoarthritis.It can obviously reduce the pain of patients, improve the function of knee joint and promote the recovery of bone and joint.

目的 探讨后稳定型全膝关节置换术患者术后股骨后髁偏距变化对早期功能的影响。方法 选取2013年1月—2016年1月我院收治的121例骨关节炎接受单侧后稳定型膝关节置换患者,记录所有患者术前与术后股骨后髁偏距,根据股骨后髁偏距变化情况分为A组(股骨后髁偏距不变或增加)与B组(股骨后髁偏距减小)。对两组患者进行至少12个月的随访,比较其骨关节炎指数评分(WOMAC)、美国膝关节协会评分(KS)、美国膝关节外科学会评分系统(HSS)及膝关节功能之间的差异。结果 术后,2组患者在前髁偏距变化、股骨假体屈曲角、胫骨后倾角、胫骨角方面差异无统计学意义(P＞0.05)。但术后1年A组患者在WOMAC评分、HSS评分和负重主动屈曲范围方面改善优于B组患者,差异有统计学意义(P＜0.05)。结论 重建股骨后髁偏距能够改善后稳定型全膝关节置换术患者术后早期的骨关节炎症状,并提升患者负重位主动屈曲范围,有一定临床价值。

Objective To explore the stabilized total knee arthroplasty effects on early functional changes of condylar offset. Methods 121 cases of posterior stabilized total knee arthroplasty in our hospital from Jan.2013 to Jan.2016 were enrolled in the study. All patients with preoperative and postoperative posterior condylar offset records, according to the changes of femoral condylar offset were divided into A group and B group. The patients in the two groups were followed for at least 12 months, and the differences in the Osteoarthritis Index score (WOMAC), the American Knee association score (KS), HSS score and knee function were compared. Results After surgery, two patients in the anterior condylar offset changes, femoral prosthesis flexion angle, tibial angle, tibial angle difference was not statistically significant (P > 0.05). But after 1 years, the improvement of WOMAC score, HSS score and weight-bearing active flexion range in group A was better than that in group B, the difference was statistically significant (P < 0.05). Conclusions The reconstruction of the posterior condylar offset can improve the stability after total knee arthroplasty in patients with early osteoarthritis symptoms, and enhance the active flexion range of patients with weight-bearing, which has some clinical value.