고도굴곡형 슬관절 인공관절 전치환술에서가동형과 고정형 삽입물의 비교
Comparison of the Mobile-bearing and Fixed-bearing Designs for High Flexion Total Knee Arthroplasty
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목적: 고도굴곡형 슬관절 인공관절 전치환술에서 가동형과 고정형 삽입물을 이용한 치료 결과를 비교 분석하였다. 대상 및 방법: 2003년 12월부터 2007년 12월까지 고도굴곡형 슬관절 인공관절 전치환술을 시행받은 환자 중 가동형 삽입물을 이용한 65예와 고정형 삽입물을 이용한 65예를 대상으로 최소 2년 이상 추시관찰 하였다. 결과: 슬관절 점수 및 기능점수는 가동형군에서 술 전 53.2점, 49.7점에서 술 후 95.6점, 96.1점으로, 고정형군에서 술 전 54.1점, 50.9점에서 술 후 94.5, 95.1점으로 향상되었다. 슬관절 운동 범위 및 최대 굴곡 각도는 가동형군에서 술 전 122.3o, 125.8o에서 술 후 129.1o, 131.4o로, 고정형군에서 술 전 122.2o, 123.9o에서 술 후 128.3o, 129.3o로 향상되었으며, 양군간에 유의한 차이는 없었다. 꿇어 앉는 자세와 양반다리 자세 가능 여부에 있어서도 양 군에서 유의한 차이는 없었으나, 가동형군에서 양반다리 자세 시 더 용이하였다. 결론: 임상적 평가지수, 슬관절 운동 범위, 최대 굴곡 각도는 양 군에서 큰 차이는 없었으나, 양반다리 자세 시 편안함을 느끼는 정도는 가동형 삽입물을 이용한 군에서 더 높았다.
Abstract
Purpose: We compared and analyzed the follow-up results of high flexion total knee arthroplasty (TKA) with using the mobile-bearing and fixed-bearing designs. Materials and Methods: We studied 130 patients who had undergone high-flexion TKA from December 2003 to December 2007 and who were followed up for at least 2 years. Of all the 130 patients, 65 patients had undergone TKA using a mobile-bearing design, and the other 65 patients had undergone TKA using the fixed-bearing design. Results: The post-operative Knee Society Knee Score (KSKS) and Knee Society Functional Score (KSFS) of the mobile-bearing group were 95.6 and 96.1 points, which were 53.2 and 49.7 points, respectively, preoperatively, and the post-operative KSKS and KSFS of the fixed-bearing group were 94.5 and 95.1 points, which were 54.1 and 50.9 points, respectively, preoperatively. The range of motion (ROM) and maximal flexion angle (MFA) of the knee joints of the mobile-bearing group were 129.1o and 131.4o, which were 122.3o and 125.8o, respectively, preoperatively, and those of the fixed-bearing group were 128.3o and 129.3o, which were 122.2o and 123.9o, respectively, preoperatively. There were no significant differences between the two groups. Crossed-legged sitting and attaining a kneeling position also showed no significant differences between the two groups, but the mobile-bearing group could easily take a crossed-legged sitting position. Conclusion: The clinical parameters and the ROM and MFA of the knee joint showed no significant differences between both groups, but the mobile-bearing group felt more comfortable in the crossed-legged sitting position.
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