影响骨关节炎患者全膝关节置换术后关节功能的相关因素分析  

Analysis of the factors influencing function of the knee after total knee arthroplasty in knee osteoarthritis

作　　者：李健[1] 刘明廷[1] 戚大春[1] 李贤让[1] 孟涛[1] 

机构地区：[1]滨州医学院附属医院骨关节外科,山东滨州256603

出　　处：《中国矫形外科杂志》2012年第8期704-707,共4页Orthopedic Journal of China

摘　　要：[目的]探讨影响骨关节炎患者全膝关节置换术后关节功能的相关因素。[方法]对41例43膝骨关节炎终末期行全膝关节置换术(total knee arthroplasty,TKA)患者术前、术后半年的膝关节功能进行HSS评分,应用Pearson相关分析及多重线性回归对术后膝关节HSS评分与患者年龄、体重指数、疼痛评分、术前膝关节活动度(ROM)、内翻畸形程度、手术前后股骨前髁偏距(ACO)变化情况,术后胫骨平台后倾角(PSA)等因素进行统计分析;并分析手术前后股骨前髁偏距(ACO)变化情况,术后胫骨平台后倾角(PSA)与术后膝关节ROM之间的关系。[结果]Pearson相关分析结果可以看出术前疼痛评分、术前膝关节ROM、术后胫骨平台PSA、手术前后股骨ACO变化与术后膝关节功能HSS评分呈正相关;体重指数、膝内翻畸形程度与术后膝关节功能HSS评分呈负相关。逐步回归分析经筛选后纳入方程的变量只有术后胫骨平台PSA(P<0.01)、术前疼痛功能评分(P<0.01)、体重指数(P<0.05),根据标准回归系数的绝对值大小排序,对应变量的作用排序为术后胫骨平台PSA(0.555)>术前疼痛评分(0.357)>体重指数(0.187)。ACO术前大于术后组的患者术后膝关节ROM明显好于ACO术前小于术后组(P<0.05)。术后胫骨平台PSA 7°～9°组术后膝关节活动度最好。[结论](1)术前疼痛评分、术前膝关节ROM、术后胫骨平台PSA、术前术后股骨ACO变化与术后膝关节HSS评分呈正相关,体重指数、膝关节内翻畸形与术后膝关节功能HSS评分呈负相关;(2)术后胫骨平台PSA、术前疼痛评分、体重指数对术后半年膝关节HSS评分影响显著;(3)股骨ACO变化对术后膝关节活动度有影响,术后胫骨平台PSA7°～9°膝关节活动度好。[ Objective]To investigate related impact factor of joint function after total knee arthroplasty. [ Method ] Preoperative and postoperative score of 41 cases （43 knees） were evaluated according to the HSS scoring system. Factors including age, body mass index, preoperative score of pain, varus degree of knee, preoperative range of motion （ ROM ）, variety of the femo- ral condyle offset （ACO）, postoperative posterior slop angle （PSA） of tibia1 plateau were analyzed by Pearson correlation and multiple linear regression. [ Result] Pearson related analysis result indicated that preoperative score of pain, preoperative range of motion （ROM） ,variety of the femoral condyle offset （ACO） ,postoperative posterior slop angle （PSA） of tibial plateau had been correlated positively with postoperative HSS score, and body mass index, varus degree of knee had been correlated negative- ly with postoperative HSS score. After the multiple linear regression analysis, postoperative posterior slop angle （PSA） of tibial plateau（ P 〈 0. 01 ）, preoperative score of pain（ P 〈 0.01 ） and body mass index （ P 〈 0.05 ） were chosen into the regression e- quation. Standardized regression coefficients：postoperative posterior slop angle （PSA） of tibial plateau （0. 555 ） 〉 preoperative score of pain （0. 357） 〉 body mass index （0. 187）. The group which knees had lowers ACO after TKA had higher ROM than higher ones. The group which postoperative posterior slop angle （PSA） of tibial plateau were 7° - 9 ° had higher ROM. [ Conclu- sion ] （ 1 ） Preoperative score of pain, preoperative range of motion （ ROM）, variety of the femoral condyle offset （ ACO）, postop- erative posterior slop angle （PSA） of tibial plateau had been correlated positively with postoperative HSS score, and body mass index, yams degree of knee are correlated negatively with postoperative HSS score. （2） Postoperative posterior slop angle （PSA） of tibial plateau, preoperative score of

关 键 词：骨关节炎 全膝关节置换术 膝关节HSS评分 影响因素 

分 类 号：R687.4[医药卫生—骨科学]