高龄骨关节炎患者膝关节置换术后功能与变量因素相关性的病例对照研究  

Case-control study of influence factors analysis on short-term recovery after total knee arthroplasty in old patients with osteoarehritis

作　　者：江敞[1] 张维康[1] 蒋垚[2] 陈黎虬[1] 

机构地区：[1]温州医学院附属温岭医院骨科,浙江温岭317500 [2]上海交通大学附属第六人民医院关节外科

出　　处：《中国骨伤》2012年第5期377-379,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨多个变量因素与术后膝关节功能HSS评分的相关性,实现对患者进行综合有效的预后判断。方法:回顾2008年3月至2010年8月应用膝关节置换术治疗72例HoldenⅣ级膝关节炎患者作为研究组,男30例,女42例;年龄60～86岁,平均(71.9±6.2)岁。关节镜下清理术治疗的22例HoldenⅣ级膝关节炎患者作为对照组,男10例,女12例;平均年龄(70.5±5.9)岁。观测术前及术后1、2周关节活动度和HSS评分,分析患者年龄、身高、体重、BMI、肌力等影响因素。评估方法主要采用HSS评分方法。结果:研究组HSS评分、ROM均提高。全膝关节置换术后2周HSS评分与术前膝关节活动度、术前HSS评分、术前膝关节疼痛、术后早期CPM应用呈正相关。全膝关节置换术后2周HSS评分与患者年龄、身高、体重、BMI、肌力等因素无显著相关。结论:患者术前膝关节活动度、HSS评分、术前疼痛、围手术期并发症以及术后CPM应用初始角度均可影响膝关节置换术疗效。Objective：To investigate the relationship between variable influence factors and postoperative 2 week hospital special surgery（HSS） of knee joint,thus offer the treatment suggestion to patients with osteoarthritis,and judge the comprehensive effective prognosis to the clinical patient. Methods：From March 2008 to August 2010,72 patients with 72 knees were treated with TKA（treatment group）,including 30 males and 42 females with a mean age of （71.9±6.2） years（ranged,60 to 86 years）. Twenty-two patients with HoldenⅣ OA treated by arthroscopy were in the control group,including 10 males and 12 females with a mean age of （70.5±5.9） years. The index including height,weight,BMI,muscle strength,knee joint HSS score and ROM were evaluated before operation and at 1st,2nd weeks after operation. Results：The HSS knee score and ROMs of patients in the treatment group improved. The pre-operative ROM,HSS score,knee pain,continous passive motion （CPM） at different level （i.e.CPM initial angle） had a prominent positive correlation with HSS score in postoperative 2 weeks. The factors such as patients＇ age,height,weight,BMI,muscular strength,etc. had no obvious relevant to HSS score in postoperative 2 weeks. Conclusion：The pre-operative HSS score,knee pain,knee ROM,perioperative severe complications,and postoperative CPM initial angle have a positive correlation with the postoperative effects.

关 键 词：骨关节炎 膝 关节成形术 置换 膝 关节镜 手术后并发症 病例对照研究 

分 类 号：R49[医药卫生—康复医学]