CⓇ SigmaTM RP-F Knee System을 이용한고도 굴곡 회전형 슬관절 전치환술 후 결과 -술 전 슬관절 운동범위 90o 미만 군과 90o 이상 군의 비교-
The Results of the P.F.CⓇ SigmaTM RP-F Knee System in High Flex Rotating Platform Total Knee Arthroplasty -Comparison of Preoperative Range of Motion less than 90o Versus more than 90o-
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목적: 퇴행성 슬관절염 환자에서 P.F.CⓇ SigmaTM RP-F Knee System을 이용한 고도 굴곡 회전(rotating platform-flexion)형 슬관절 전치환술 후, 술 전 관절운동범위가 90o 미만인 군과 90o 이상인 군의 임상적, 방사선학적 결과를 비교하고자 한다. 대상 및 방법: 2005년 1월부터 2006년 11월까지 P.F.CⓇ SigmaTM RP-F Knee System을 이용하여 슬관절 전치환술을 시행한 후, 이중 최소 3년 이상 추시가 가능한 82예를 대상으로 술 전 관절 운동 범위가 90o 미만인 34예와 90o 이상인 48예로 구분하여 수술 전과 최종 추시시 관절 운동 범위, Hospital for Special Surgery (HSS) 점수, Knee Society Score (KSS), Western Ontario and MacMaster Universities Osteoarthritis (WOMAC) 점수를 이용한 임상적 평가와 대퇴경골각, 치환물의 해리 및 방사선 투과선 등의 방사선적 평가를 비교 분석하였다. 결과: 술 후 최종 추시상 술 전 관절 운동 범위가 90o 미만인 군과 90o 이상인 군에서 관절 운동 범위는 두 군 모두에서 증가되었으며, 90o 미만인 군에서 운동 범위의 증가폭이 통계학적으로 유의하게 증가되었다(p=0.038). 또한 각각의 HSS 점수, KSS 점수, WOMAC 점수는 두 군에서 모두 유의하게 증가되었으나, 두 군간의 비교에서는 통계학적 의미는 없었다. 방사선 검사상 대퇴경골각은 두 군에서 모두 술 전에 비해 술 후 평균 외반 4.8o로 교정되었으며, 치환물의 조기 해리나 방사선 투과선 등은 발견되지 않았다. 결론: P.F.CⓇ SigmaTM RP-F Knee System을 이용한 슬관절 전치환술은 고도 굴곡을 원하는 환자에게 좋은 수술 방법으로 생각되며, 특히 술 전 운동 범위가 불량한 환자에서 유용하게 사용될 수 있는 것으로 생각된다.
Abstract
Purpose: The purpose of this study was to evaluate the clinical and radiological results of using the P.F.CⓇ SigmaTM RP-F Knee System for high flex rotating platform-flexion total knee arthroplasty in 2 groups of patients with a preoperative range of motion (ROM) less than 90 degrees or more than 90 degrees, respectively. Materials and Methods: From January 2005 to November 2006, eighty-two patients received the P.F.CⓇ SigmaTM RP-F Knee System for high flex rotating platform total knee arthroplasty, and they were evaluated for a minimum of 3 years. We subdivided the patients into two groups: the preoperative ROM less than 90o group and the more than 90o group. The clinical results were assessed using the ROM, the Hospital for Special Surgery (HSS) score, the Knee Society Score (KSS) and the Western Ontario and MacMaster Universities Osteoarthritis (WOMAC) score. The radiological results were evaluated using the tibio-femoral angle and the presence of loosening or osteolysis of the components. Results: The ROM increased in the two groups at the last follow-up. The mean ROM range at the last follow up was significantly increased more in the less than 90o group compared to that in the more than 90o group. The HSS score, KSS, and WOMAC score significantly increased in the two groups, but there was no statistical difference between the two groups. The tibio-femoral angle improved in the two groups. There was no aseptic loosening or osteolysis. Conclusion: The postoperative clinical and radiological measures were significantly improved using the P.F.CⓇ SigmaTM RP-F Knee System on the short term follow-up, and especially for the patients whose preoperative ROM was poor.
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