摘要 目的 比较经股内侧肌入路与内侧髌旁入路行全膝关节置换术的临床疗效。 方法 25例行同期双侧全膝关节置换术，每例患者随机一侧采用经股内侧肌入路，另一侧采用内侧髌旁入路，观察两组手术时间、术后引流量、术后6周关节活动度、直腿抬高恢复时间，术后第1、2、3、6天对每例患者双侧膝关节进行视觉模拟疼痛评分（visual analog scale，VAS）。 结果 经股内侧肌入路组在直腿抬高恢复时间［（2.2±0.8） d vs （4.4±1.4）d］、VAS评分方面明显优于内侧髌旁入路组( P <0．05 )，两组在术后引流量、手术时间、术后6周膝关节活动度方面差异无统计学意义( P >0．05)。 结论 经股内侧肌入路行全膝关节置换术与髌旁入路相比，可以减轻术后的疼痛，减少直腿抬高恢复时间，较早恢复膝关节功能，值得临床推广和应用。
Abstract：Objective To investigate the clinical difference between midvastus and medial parapatellar approaches in total knee arthroplasty. Methods Twenty-five patients undergoing bilateral total knee arthroplasty in this hospital from January 2009 to January 2010 were retrospectively studied. One randomized side of each patient was treated using the midvastus approach and the other side using the medial parapatellar approach.The operation duration, postoperative drainage amount,range of motion 6 weeks after operation, time to resume straight leg raises and the VAS score of each knee in the postoperative 1,2,3 and 6 days were observed. Results The midvastus approach group far outperformed the medial parapatellar approach group in the time to resume straight leg raises and VAS scores(P<0.05). However，they had no significant difference in the drainage amount,operation duration and range of motion 6 weeks after operation (P >0．05). Conclusions Compared with midial parapatellar approach, the midvastus approach in total knee arthroplasty causes less pain postoperatively, takes less time to resume straight leg raises and brings about quick recovery to knee function.
