目的 探讨单侧双通道内镜下椎板开窗减压术在腰椎管狭窄症中的应用.方法 回顾性分析2019年11月至2021年11月石河子市人民医院收治的39例保守治疗无效单侧下肢症状的腰椎管狭窄症患者的资料.其中,男19例,女20例;年龄55～80岁,平均60.5岁;病程4～25周,平均12.5周.病变节段L3-45例,L4-530例,L5-S14例.记录手术时间、术中出血量、手术切口长度及并发症发生情况.采用疼痛视觉模拟评分法(VAS)和改良的Oswestry功能障碍指数(ODI)比较术前、术后1d及术后1个月、3个月、1年和末次随访的结果评估手术疗效.末次随访时按MacNab标准评估治疗有效率.结果 所有患者均顺利完成手术,并均获得随访,随访时间为12～23个月,平均(16.2±3.2)个月.患者的手术时间为(61.55±5.36)min、术中出血量为(50.20±7.53)mL、手术切口长度为(14.26±2.66)cm.术后各时间点腰腿疼痛VAS评分及ODI较术前均明显下降,差异有统计学意义(P＜0.05);术后各时间点间比较,差异无统计学意义(P＞0.05).术后有1例出现下肢麻木,感觉过敏;有2例患者硬膜囊撕裂;无感染发生.结论 在腰椎管狭窄症中应用UBE行镜下椎板开窗减压术是安全、有效的,为腰椎管狭窄症的微创治疗提供了选择.

目的 比较双通道内镜与椎间孔镜椎板开窗减压术在腰椎管狭窄症中应用的疗效.方法 回顾性分析2019年11月-2021年11月,共75例保守治疗无效单侧下肢症状的腰椎管狭窄症患者纳入本研究.PELD组:36例,UBE组:39例.比较两组手术时间、术中出血量、手术切口长度以及并发症发生情况.采用疼痛视觉模拟评分法(Visual Analogue Scale,VAS)和改良的Oswestry功能障碍指数(Oswestry Disability Index,ODI)比较手术前、术后1 d及术后1、3个月、1年和末次随访的结果评估手术疗效.结果 两组患者均顺利完成手术,两组患者均获得随访,随访时间为12-23个月,其中UBE组随访时间平均为(16.2±3.2)个月,PELD组随访时间平均为(16.6±3.0)个月.手术时间、出血量方面差异无统计学意义(P＞0.05).手术切口长度上比较差异具有统计学意义(P＜0.05).术后各时间点两组腰腿疼痛VAS评分及ODI较术前均明显下降,差异有统计学意义(P＜0.05),各时间点两组间比较差异无统计学意义(P＞0.05).UBE组和PELD组各有1例术后出现下肢麻木,感觉过敏.UBE组有2例患者硬膜撕裂.PELD组有1例出现症状性硬膜外血肿尿潴留,1例患者棘突根部骨折.两组均为无感染发生.结论 应用PELD和UBE行镜下椎板开窗减压术治疗腰椎管狭窄症是安全的、有效的.

目的:讨论克氏针锚定技术辅助椎间孔镜下可视化关节突成型的可行性及临床疗效.方法:回顾2019年1月-2021年1月行椎间孔镜手术并获得完整随访的60例腰椎间盘突出症(LDH)患者的临床资料.对照组(30例)使用常规椎间孔镜下可视化成型技术,实验组(30例)使用克氏针锚定技术辅助下可视化成型技术;比较两组不同成型方法下手术时长、术中透视次数、成型时及术后第1天VAS评分、术后第1天ODI评分.结果:所有患者均在局麻下顺利完成椎间孔镜下关节突成型、髓核摘除术,实验组平均手术时长(41.22±2.21)min;术中平均透视(2.11±0.56)次,成型时VAS评分为(4.10±0.21)分,术后第1天VAS评分为(2.33±0.14)分,术后第1天ODI评分为(20.20±1.15);对照组:平均手术时长(55.22±6.21)min;术中平均透视(5.13±0.37)次,成型时VAS评分为(4.52± 0.26)分,术后第1天VAS评分为(2.27±0.41)分,术后第1天ODI评分为(20.71±1.50).两组均无神经损伤、硬膜撕裂和切口感染等早期并发症发生.两组比较手术平均时长及透视次数差异具有统计学意义(P＜0.05),成型时及术后VAS评分、术后ODI评分两组比较差异无统计学意义(P＞0.05).结论:克氏针锚定技术辅助椎间孔镜下可视化成型技术疗效确切,安全性高,可有效降低椎间孔镜下关节突成型的学习曲线,缩短手术时间,减少透视次数,值得推广应用.

目的:探讨椎间孔镜下椎间盘髓核摘除术围手术期不同护理措施围手术期效果.方法:选取2018年5月-2019年5月在石河子市人民医院骨科行腰椎间盘突出症髓核摘除术患者84例,其中41例采用常规护理干预(对照组),43例采用针对性护理干预(干预组),比较两组手术前、后VAS评分,ODI评分及患者满意度.结果:对照组手术前VAS评分为(7.21±4.18),手术后为(2.35±1.02),差异有统计学意义;干预组手术前VAS评分为(7.34±2.53),手术后为(2.78±1.21),差异有统计学意义;干预后两组间患者视觉模拟评分法(VAS)评分比较,差异无统计学意义(P＞0.05).对照组术前ODI评分为(31.37±3.45),术后为(16.12±4.52),差异有统计学意义;干预组术前ODI评分为(32.74±2.85),治疗后为(16.08±3.41),差异有统计学意义;干预后两组患者的ODI评分比较,差异无统计学意义(P＞0.05).两组患者术后满意度比较,对照组87.8％,干预组95.3％,差异有统计学意义(P＜0.05).结论:围手术期采用针对性护理干预能够提高椎间孔镜下髓核摘除术患者术后护理满意度.

目的 研究经皮椎间孔镜技术治疗腰椎间盘突出症发生类脊髓高压症的原因及治疗对策.方法 回顾性研究石河子市人民医院骨一科自2017年10月-2019年12月期间;接受经皮椎间孔镜技术治疗腰椎间盘突出症患者60例;其中男性30例,女性30例;年龄27-66岁,年龄<50岁30人,年龄>50岁30人,平均47.51±2.66岁,病变节段:L3-410例,L4-533例;L5-S117例.结果 60例手术患者中出现硬膜破裂2例;患者均出现不同程度头疼、颈部僵硬,其中1例患者出现严重头疼及呕吐,终止手术;手术水袋高于1.90米时更容易诱发患者出现不同程度的不适;所有类脊髓高压症均出现在局部麻醉手术中;患者年龄越大、手术时间越长患者就更容易出现头、颈部不适.结论 患者年龄大小,硬膜破裂与否,手术时长,灌洗液水压高低都是引起类脊髓高压症的危险因素,手术中需警惕.

目的:探讨经部分椎弓根终板下楔形截骨术治疗陈旧性胸腰椎骨折合并后凸畸形的临床效果.方法:对所有患者均采用单纯后路经部分椎弓根终板下楔形截骨术,同时应用椎弓根螺钉内固定脊柱,重建脊柱矢状面平衡.结果:陈旧性胸腰椎骨折合并后凸畸形患者13例,其中男5例,女8例;年龄25～ 55岁(38.1±13.5)岁;11例有进行性腰背部疼痛、平卧困难,4例伴有不同程度神经损害症状(Frankel分级显示C级1例,D级3例);术前Cobb's角25～71°,平均(44.6±23.2)°;手术时间115～210分钟,平均(151.1±17.6)分钟;术中出血量860～1500mL,平均(1200.1±176)mL;浓缩红细胞输注2～7u(4.2±3.6)u;纳入的病例术后均未发生感染、神经损伤、脑脊液漏等并发症;术后Cobb's角0～9.2°,平均(5.3±4.1)°,与术前相比差异具有显著统计学意义(P＜0.05);术后即刻畸形矫正率80.3％;随访时间9个月～4年(23.2±10.4)月,末次随访平均矫正度数丢失2.1°;按Frankel分级,3例D级神经功能恢复正常,1例C级恢复到D级.结论:经部分椎弓根终板下楔形截骨术治疗陈旧性胸腰椎骨折合并后凸畸形得到满意的矫正,但是本研究为单中心的回顾性研究,且纳入的样本量较小,仍有必要开展进一步研究.

目的 对比分析外固定架联合克氏针与掌侧固定板治疗桡骨远端粉碎性骨折的临床效果.方法 研究选择60例桡骨远端粉碎性骨折患者作为研究对象,根据治疗方法的差异将入组患者分成实验组和对照组,分别采取外固定架联合克氏针治疗和掌侧固定板治疗,对比两组患者的术后6个月的腕关节Cooney评分、骨折愈合时间、并发症发生情况和患者满意度.结果 术后6个月两组患者的腕关节评分均有所上升,实验组的评分显著高于对照组(P＜0.05);实验组的骨折愈合时间显著低于对照组(P＜0.05),两组的术后并发症和患者满意度无明显差异(P＞0.05).结论 在桡骨远端粉碎性骨折治疗中,相较于掌侧固定板治疗,外固定架联合克氏针治疗在治疗的及时性和有效性上具有更加显著的优势,且不会增加患者术后并发症风险,治疗的安全性有所保障,适宜在临床治疗中广泛应用.

目的:探讨选择性神经根封闭治疗腰椎间盘突出症的优点及可行性.方法:选取2017年5月至2018年12月收治的共60例腰椎间盘突出症患者,按治疗方法不同分为研究组与对照组,研究组采用C臂引导下选择性神经根封闭注射治疗;对照组采用传统药物及物理治疗;对比两组患者Oswestry功能障碍指数评分(ODI)、疼痛视觉评分(VAS)、住院总天数、住院总费用.结果:所有患者均完成治疗及随访,其中研究组1例出现复发,给予椎间孔镜治疗后痊愈;研究组经封闭治疗后1天,1、3、6和12个月的VAS及ODI评分均优于对照组,差异有统计学意义;研究组治疗费用(1921.13±421.38)元,对照组(2871.28±455.8 5)元,两组比较差异有统计学意义;研究组住院天数(3.01±0.28)天,优于对照组11天,P＜0.05,差异有统计学意义.结论:C臂引导下选择性神经根封闭术治疗对于腰椎间盘突出症疗效显著,住院时间更短,花费更少,值得临床推广应用.

In order to treat cervical spondylotic radiculopathy, analyze the factors of compression of the nerve root in the intervertebral foramen and help select the appropriate decompression method, we measured the intervertebral foramen area of patients with cervical spondylosis by imaging technology, and evaluated the degree of nerve root compression and the compression factor in this study. 47 cases treated by anterior approach decompression of unilateral nerve root type cervical spondylosis which were caused by compression of nerve root in intervertebral foramen from January 2011 to January 2016 were selected as experimental objects, and these cases were divided into two groups: 21 cases with not decompression in the intervertebral foramen (group Ⅰ), and26 caseswere decompressed in the intervertebral foramen (group Ⅱ) according to preoperative imaging data. The two groups were both treated with anterior cervical discectomy and internal fixation, and group Ⅰ received anterior cervical discoidectomy while group Ⅱ received decompression of intervertebral foramen based on group Ⅰ. Surgimap software was used to analyze the intervertebral foramen area at both sides of lesion segment of groupⅠ by MRI (T2W1 sagittal plane) and group Ⅱ by CT (2D reconstruction sagittal, bone window). We compared two groups of patients with intervertebral foramen area of the healthy side and the affected side before operation, then we made the comparison of the affected area of intervertebral foramen between the preoperation and postoperation. The VAS score and NDI score before operation and 6 months after operation were compared, and47 cases were all followed up for 6～12 months. The results showed that all patients had clinical symptoms relieved, and there were no complications such as infection, internal fixation loosening, esophageal fistula and other complications, which indicated that preoperative measurement of intervertebral foramen area, evaluation of compression degree, and analysis of compression factor according to iconography could do a help in choosing the appropriate decompression method.

目的:探讨采用跟骨锁定钛板结合同种异体骨移植治疗跟骨关节内骨折32例(36足)疗效分析.方法:通过对我院2010年12月至2015年12月收治的32例(36足)跟骨关节内骨折患者,按照Sanders分型分为Ⅱ型14组,Ⅲ型16组,Ⅳ型6组.全部病例均采用跟骨外侧入路,切开复位跟骨锁定钛板内固定结合同种异体骨移植治疗.随访观察患足功能恢复及并发症发生情况,并比较手术前后的Bohler角、Gissane角、跟骨高度和跟骨宽度.结果:经过8～18个月后随访,平均11个月.32例骨折全部骨性愈合,愈合时间平均为12.8周,术后并发症发生率为8.3％.按Maryland足部评分系统评价术后10个月患足的功能.结果:优24组,良8组,可4组,优良率89％.术后Bohler角、Gissane角及跟骨高度、宽度、长度均恢复到正常范围.结论:跟骨锁定钛板结合同种异体骨移植治疗跟骨关节内骨折,达到解剖复位,恢复距下关节关系;内固定坚强,植骨牢固,可早期功能锻炼,取得满意疗效.

目的 探讨椎体静脉造影在经皮椎体成形术(PVP)治疗伴有椎体真空征的骨质疏松性胸腰椎骨折中的应用.方法 回顾性分析自2010-02-2015-02采用PVP治疗的73例(73个椎体)椎体内真空裂隙骨质疏松性胸腰椎骨折.术中行椎体静脉造影后注射骨水泥.观察造影剂的渗漏情况及其在椎体内的分布特征,记录术中骨水泥注入量,比较术前、术后1个月、术后1年的VAS评分及ODI指数.结果 术中椎体静脉造影后透视显示66例(90.4％)造影剂均在椎体内、裂隙内填充;7例(9.6％)有造影剂渗出,其中3例为椎体周围渗漏,2例为椎间盘渗漏,2例为椎管内渗漏.骨水泥注入量3.1～5.5 ml,平均4.2 ml.本组均获得随访12～24个月,平均18个月.术后1个月、1年的VAS评分及ODI指数较术前明显降低,差异有统计学意义(P＜0.05).术后1年与术后1个月的VAS评分、ODI指数比较差异无统计学意义(P＞0.05).结论 PVP治疗伴有椎体真空征的骨质疏松性椎体骨折术中行椎体静脉造影能够预见骨水泥流动分布特征以减少骨水泥的渗出,提高手术安全性.

Objective To explore the effect of the posterior ligament complex on the adjacent segment degeneration after posterior lumbar interbody fusion.Methods FromJ anuary 2000 to January 2010,60 patients were treated by posterior lumbar interbody fusion(PLIF)and internal fixation with posterior lumbar interbody fusion(L4~5). Group A(30 cases):the PLIF group(30 cases)underwent PLIF with posterior ligament complex conserved,B group( cases):PLIF with posterior ligament complex resected. We compared the JOA score,improve rate before and after surgery of the two groups. At the end of the opera-tion,the height of lumbar 3 ~4 intervertebral disc and the dynamic angle of lumbar intervertebral space were measured and compared with the lumbar 3~4 intervertebral disc. Before and at the end of the follow-up,the 3~4 lumbar intervertebral disc wasgradedaccordingtoPfirrmanngrade.Results There was significant difference in JOA score before and after operation(P<0. 05)in both group. There was no significant difference between the two groups(P>0. 05). A group had 9 patients with lumbar 3/4 segment of the ASD,B group had 17 cases of lumbar 3~4 segment ASD. Among them,each groups had 2 cases of patients with symptoms of ASD. There were not difference in 3~4 lumbar intervertebral disc height,intervertebral space dy-namic angle ,waist 3 ~ 4 vertebral slip distance . But at the time of last follow - up significant difference could be found( P <0. 05). At the end of the follow-up A group had 6 cases of Pfirrmann grade 1,22 cases of 2,2 cases of grade 3,no 4,5 cases. Bgroup had 4 cases of Pfirrmann grade 1,24 cases of 2,2 cases of grade 3,no 4,5 cases.Conclusion Inlumbarinterbody fusion,posterior ligament complex can decrease the incidence of adjacent segment degeneration.

目的:探讨应用球囊单侧入路椎体成形术(PKP术)治疗骨质疏松性椎体压缩性骨折的临床疗效.方法:回顾性分析2012年06月～2015年12月应用球囊单侧入路椎体后凸成形术治疗的96例患者,术后应用疼痛评分(Visual analog scale,VAS)对患者术前、术后2周、术后1年的疼痛程度进行评价,并测量骨折椎体的前缘高度和局部后凸角,使用SF-36生活质量调查表对患者术前及术后2周、术后1年随访时的生活质量(Quality of life,QOL)进行评分,并进行比较.结果:患者术后的VAS分值均明显低于术前,且差异具有统计学意义(P＜0.01),椎体前缘高度均明显增高,局部后凸角得到明显改善,患者的SF-36问卷的相关指标均较术前明显改善(P＜0.01).结论:应用球囊单侧入路椎体成形术(PKP)可明显缓解疼痛,在恢复并维持椎体高度、纠正后凸畸形方面均有明显效果,同时可显著提高患者的QOL,使患者能够很快的从疾病的阴影中走出来,精神压力减轻,从而提高了社会功能.

目的探讨人工膝关节置换术各项医疗费用组成及其特点。方法对2009年~2013年在我院行TKA患者的各项医疗费用进行分析比较；同时与国内外知名医院数据进行对比；调查患者付费与医保支付的比例。结果2009年~2013年间在我院接受TKA的平均住院费用国产深盘型假体组为：34450元，国产状柱型假体组为：40555元，进口固定平台组为：51028元，进口旋转平台组：58173元。各项费用对比显示国产假体费用占总费用的43.2%~44.7%，进口假体费用占总费用的61.5%~73.4%，假体费、检查费和药品费占总费用的比例明显高于其他项目。使用不同的膝关节假体患者及医保的支付比例不同，但是术后疗效无差异。各项费用中体现医护技术水平和价值的费用比例低于国外，而与国内相当。结论合理的调整膝关节置换术各项医疗费用的组成，有利于膝关节置换术在我国的发展。

[目的]探讨A型(AO分型)胸腰椎骨折的患者,应用术前MRI中椎间盘组织的影像学特点评估患者预后疗效的可行性,为A型胸腰椎骨折临床治疗提供理论依据.[方法]分析2008年1月～2012年6月收治的90例胸腰椎骨折患者术前的MRI资料,按照椎间盘损伤的影像学特点分为3组(A、B、C组),每组30例,所有患者均采用传统短节段椎弓根钉固定结合伤椎置钉并椎体内植骨进行治疗,分别测量术后2周、术后1年、内固定取出半年的疼痛评分(VAS)、Cobb角及伤椎前高率,并做统计学分析.[结果]术后平均随访19.3个月(15 ～ 23个月),无断钉、断棒及内固定松动发生,所有伤口均Ⅰ期愈合,未出现其他并发症.术后1年时,C组患者的Cobb角与A、B组比较差异有统计学意义(P＜0.01),内固定取出半年时,C组患者的三项检查指标[疼痛评分(VAS)、Cobb角、伤椎前高率]与A、B组比较差异均有统计学意义(P＜0.01).[结论]MRI检查是判断椎间盘损伤的重要手段,通过本项研究,作者认为术前MRI表现符合C组的患者,无论前路还是后路手术,切除受损的椎间盘组织同时行牢固的植骨融合内固定是手术的重要目的之一.

Objective To investigate the feasibility of application of preoperative MRI intervertebral disc tissue ima-ging assessment prognosis effect in type A thoracolumbar fractures( AO classification) . Methods 90 consecutive pa-tients suffered from lumbar fracture were examined by MRI. According to the imaging characteristics of intervertebral disc injury were divided into 3 groups (group A, B and C), 30 cases of each group. All patients were treated by short-segment pedicle screw fixation combined with bone graft of vertebral body via pedicle. Three times point ( 2 weeks after operation,1 year after operation and six months after surgery to remove the internal fixation),these pa-tients were evaluated with X-ray for Cobb angle and visual analog scale( VAS) . Results All patients were followed up for 15~23 months. All the fractures were reduced and the internal fixation was not loosened or broken. There was no correction loss or other complications. Compared with group A and B, 1 year after operation,Cobb angle in group C showed significant difference (P<0. 01);six months after surgery to remove the internal fixation, the Cobb angle and VAS in group C showed significant difference (P<0. 01). Conclusions MRI is an important method to determine the injury of intervertebral disc. The patients with severe disc injury preoperative shown on MRI can not get satisfied out-come in VAS score and Cobb angle.

Objective To explore the effect of the deep disc prosthesis on the early curative effect of the total knee arthroplasty (TKA).Methods From June 2006 to January 2012, in our hospital, 76 cases of deep-disc type spacer prosthesis TKA (97 knees) were followed up.The follow-up time was 2-6 years, 4.2 years in average, including 65 females and 11 males.The age was from 55 to 78 years old, 65. 8 years in average.There were 76 healthy volunteers, aged from 18 to 42 years old, 30.5 years in average, who were randomly chosen for the right or left knee as control .The preoperative and postoperative KSS score, knee joint function score, ROM knee, and the posterior condylar offset of the TIKA group were compared.compared with TKA group and volunteer groups of the tibia shifting distance of the TKA group and volunteer group was compared .The femoral translation during the knee position changed from extension to the maximum flexion was compared between the TKA group and the volunteer group .Results The differences in KSS score , knee joint function score , and ROM of the TKA group before and after operation were statistically significant ( P<0.05 ) , while there was no significant difference in the difference of the posterior condylar offset before and after the surgery ( P>0.05 ) .The femoral translation during the knee position changed from extension to the maximum flexion was (6.24 ±2.45) mm in the TKA group, and the distance was (10.87 ±1.49) mm in the volunteer group , the difference was statistically significant ( P<0.05 ) .There was superficial wound infection in one case , and it was cured after the treatment .There was one case of the periprosthesis infection , which was healed after the second stage revision .Postoperative follow-up X-ray imaging showed that the prosthesis position , force lines, and the fixation performance were good, and there was no loosening , radiolucent lines and other abnormalities .Conclusion The use of deep disc prosthesis in TKA provides a satisfactory initial clinical curative effect; the femoral translation during the knee position changes was smaller in the TKA group than the volunteer group .

目的:探讨经皮椎体成形术治疗椎体肿瘤的疗效和安全性.方法:17例患者共41个椎体肿瘤行经皮椎体后凸成形术治疗,术前临床症状及术后临床效果均采用疼痛视觉模糊评分进行评定.结果:所有患者术后24小时内疼痛症状明显缓解或消失.随访2-6个月,平均3.5个月,患者未诉疼痛加重,未出现严重并发症.结论:椎体成形术治疗椎体肿瘤能迅速缓解疼痛,改善临床症状及提高生活质量,有较高的临床应用价值.

BACKGROUND:Deluxe-PS knee prosthesis is designed based on the anatomical characteristics of the Chinese peoples’ knee joint, especial y the morphological features of femoral condyle. The distance between median and lateral knee prosthesis femoral condyle is less than that of the imported prosthesis for 3.5 mm. <br> OBJECTIVE:To explore the short-term efficacy of Deluxe-ps knee prosthesis in simultaneous bilateral total knee arthroplasty. <br> METHODS:Fifteen knee osteoarthritis patients (30 knees) were included as the experimental group, and treated with simultaneous bilateral knee arthroplasty by Deluxe-ps knee prosthesis. Twenty patients (40 knees) in the control group were treated with simultaneous bilateral knee arthroplasty by PFCSigma knee prosthesis. The knee society score, hospital for special surgery knee score and knee joint range of motion were compared between two groups;the operation time and the intraoperative blood loss were compared between two groups. <br> RESULTS AND CONCLUSION:The patients in both groups were fol owed-up for 12 to 24 months, with an average of 16 months. Postoperative knee pain was relieved, and the joint function was recovered satisfactorily. The knee society score, hospital for special surgery knee score and knee joint range of motion in two groups were improved significantly after treatment (P<0.05). There were no significant differences in postoperative knee society score, hospital for special surgery knee score and knee joint range of motion between two groups (P>0.05), and there was no significant difference in intraoperative blood loss between two groups (P>0.05), while there was significant difference in operation time between two groups (P<0.05). The results showed that the short-term effect of Deluxe-ps knee prosthesis in simultaneous bilateral total knee arthroplasty was satisfied.

[Objective]The application of TC - Dynamic knee prostheses was explored in TKA(total knee arthroplasty). [Methods]TKA was conducted in the test group(40 patients,50 knees) with TC - Dynamic knee prostheses and the control group(40 patients,45 knees) with Depuy P.F.C.Sigma knee prostheses from October 2005 to December 2010.The two groups were evaluated and compared in preoperative and postoperative scores of KSS,function and Peller,knee joint ROM,postoperative anterior knee pain and patellar clunk.[Results]The differences were significant between preoperative scores of KSS, function and Feller and knee joint ROM and postoperative for either group(P<0.05).The differences were not significant in postoperative scores of KSS,function and Feller and knee joint ROM between the two groups(P>0.05).Ten minutes could be saved at least by using TC - Dynamic knee prostheses instead of Depuy P.F.C.Sigma knee prostheses for TKA.A patient(a knee) appeared anterior knee pain and a patient(a knee) appeared patellar clunk in the test group.Two patients(two knees) appeared anterior knee pain and three patients(three knees) appeared patellar clunk in the control group.The position,lines of force and fixed performance were fine with follow - up X - ray for the knee prostheses in the two groups.There was no loosening, radiolucent line and so on.[Conclusion]TC - Dynamic knee prostheses is satisfactory in curative effect for TKA and the function of prostheses is good after operation.