膝关节表面置换术治疗重度膝关节骨关节病近期疗效及影响因素分析  

Influence Factors Analysis and Recent Effect on the Treatment of Severe Knee Osteoarthrosis with Total Knee Replacement

作　　者：宋文泉[1] 唐征宇[1] 李宝林[1] 林振群[1] 

机构地区：[1]安徽省蚌埠市第一人民医院骨科,233000

出　　处：《解剖与临床》2012年第4期285-287,共3页Anatomy and Clinics

摘　　要：目的：探讨人工膝关节表面置换术治疗重度膝关节骨关节病的近期临床疗效及相关影响因素。方法：自2011年1月至2011年11月，采用人工膝关节表面置换术治疗膝关节重度骨关节病18例24膝，其中类风湿关节炎5例、晚期膝关节退变性骨关节炎12例和创伤性骨关节炎1例；18例中，PS型固定平台假体14例，CR型旋转平台假体4例。术后早期行功能锻炼。应用HSS膝关节评分系统进行疗效分析。结果：本组18例24膝术后膝关节疼痛基本消失，关节功能明显改善。术后均获随访6—16个月。术后4个月膝关节HSS评分平均91．9分，其中优14膝、良8膝、可2膝，优良率91．7％。结论：膝关节表面置换是重度膝关节骨关节病患者解除病痛、改善关节功能的有效治疗手段；术中关节周围挛缩软组织能否得到充分松解、胫骨截骨是否恰当，术后功能锻炼是否规范等，均是影响手术疗效的重要因素。Objective：To explore the recent effect and influencing factors of severe knee osteoarthrosis with total knee replacement. Methods：From Jan. 2011 to Nov. 2011, 18 cases （24 knees） of severe knee osteoarthrosis were treated with total knee replacement, among which,5 cases of arthritis pauperum, 12 cases of cataplasia osteoarthrosis, 1 case of traumatic osteoarthrosis. Among of them, 14 cases were performed PS, 4 cases were CR. The curative effect was observed and evaluated by HSS scoring system after operation. The patients accepted functional exercises after operation early. Results：18 cases （24 knees） who were performed total knee replacement recovered satisfactorily and the knee function improved significantly. All patients were followed up from 6 to 16 months after operation. According to HSS grade standard, the average score was 91.9, the results were calssified as excellent in 14 knees, good in 8 knees, fair in 2 knees, and poor in 0 knee at 4 months after operation. The excellent and good rate was 91.7%. Conclusions：The artificial total knee replace- ment is an effective treatment method for severe knee osteoarthritis, which can relieve pain of disease and improve the function of joint. Fully releasing contractures of soft tissue around the joints and appropriate tibia osteotomy during operation and reasonably functional exercises after operation are important factors that affect the efficacy of operation.

关 键 词：膝关节表面置换 骨关节病 人工关节 影响因素 

分 类 号：R687.4[医药卫生—骨科学]