膝外翻畸形患者的全膝关节置换手术综述 作者：宣超杰吕帅洁童培建来源：《上海医药》第 07 期 摘 要 膝外翻畸形常合并有某些骨与软组织的特性性变化，全膝关节置换术旨在矫正外翻畸形，恢复下肢力线。术前负重位的双下肢全长片有助于测量下肢力线与解剖轴关系。手术多采用前内侧入路，切骨时，注意股骨和胫骨的切骨平面、角度和厚度，如有骨缺损，需进行修复。外翻畸形时内外侧软组织失衡，通过松解平衡后恢复关节力线，但是具体软组织松解方略仍有争议。假体选择亦至关重要，直接影响术后疗效和使用寿命等，应结合患者关节及软组织综合考虑。术后注意有无腓总神经损伤，早期功效锻炼，恢复关节活动能力。 核心词 膝外翻畸形 全膝关节置换 综述 中图分类号：R687.42 文献标记码：A 文章编号：1006-1533（）07-0057-06 ABSTRACT Valgus deformity is often associated with some characteristic changes in bone and soft tissue. Total knee arthroplasty （TKA ） is aimed at correcting valgus deformity and restoring lower limb alignment. Preoperative weight-bearing full-length film of the lower limbs is useful to measure the limb alignment and anatomical axis. The anteromedial approach is used by the majority of surgeons. In order to make the right cut ， the surgeon should pay attention to osteotomy plane ，angle and thickness of the femur and tibia ， then repair the bone defects. The joint force lines can be restored by soft tissue contraction or elongation ， but the release strategy is still controversial. Suitable prosthesis has important implication to the postoperative efficacy and secondary renovation. Attention should be paid to peroneal nerve status after surgery and early exercise to restore joint mobility. KEY WORDS knee valgus deformity ； total knee arthroplasty ； overview 膝外翻畸形相对膝内翻畸形而言，比较少见，约占全膝关节置换术（total knee arthroplasty，TKA）患者的 10%[1]。膝外翻畸形往往伴有不同程度的骨或软组织的解剖变异，如股骨髁发育不良、髌骨轨迹变...
