严重屈曲畸形膝的人工膝关节置换术  

Total knee arthroplasty in patients with severe flexion contracture knees

作　　者：褚亚明[1,2] 周一新[1,2] 李玉军[1,2] 

机构地区：[1]北京积水潭医院 [2]北京大学第四临床医学院矫形骨科,北京市100035

出　　处：《中国骨与关节损伤杂志》2012年第12期1090-1092,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的 探讨病变晚期的严重屈曲畸形膝关节行人工全膝关节置换术的临床疗效。方法自2007年6月-2010年5月行人工全膝关节置换术的严重屈曲畸形112例（173膝）为A组（术前膝关节屈曲畸形≥20°），并随机选出同期手术的术前屈曲畸形小于20°者150例（214膝）为B组，随访1年以上，观察各组膝关节活动度、KSS评分、WOMAC评分的变化。结果术后所有患者的膝关节活动度、KSS评分及WOMAC评分和术前相比差异有统计学意义（P〈0．05），术后A、B两组的浯动度较术前分别增加了44．6°、22．6°，其中伸直活动度分别增加了25.3°、5.3°，屈曲活动度分别增加了19．3°、17.3°，KSS临床评分分别增加了69．0、45．8分，功能评分分别增加了33.5、32．5分，WOMAC疼痛评分分别减少了9．8、8．8分，僵硬评分分别减少了3．9、3．2分，功能评分分别减少了32．3、29．1分。结论严重屈曲畸形的膝关节在关节置换术后能够获得很好的活动度和功能。Objective To investigate the outcome of total knee arthroplasty in patients with severe flexion contracture knees. Methods From June 2007 to May 2010, 262 patients underwent total knee arthroplasty. According to the preoperative flexion contracture degrees, these patients were divided into two groups. A group （flexion contracture degree ≥20° ）included 112 patients（173 knees）, B group（flexion contracture degree〈20°）included 150 patients （214 knees）. These patients were followed up for at least one year and the change of ROM, KSS score and WOMAC score was observed. Results As a result of the arthroplasty, the ROM, KSS score and WOMAC score of all patients had significant improvement after operation. The ROM of knees respectively increased by 44.6°, 22.6° after operation and the extension increased by 25.3°, 5.3° and the flexion increased by 19.3°, 17.3°in group A,B. The KSS score increased by 69.0, 45.8 and the KSS function score increased by 33.5, 32.5 in group A,B. The WOMAC pain score decreased by 9.8, 8.8 and the WOMAC stiff score decreased by 3.9, 3.2 and the WOMAC function score decreased by 32.3, 29.1 in group A,B. Conclusion The patients with severe flexion contraeture knees could gain good ROM and function after total knee arthroplasty.

关 键 词：人工全膝关节置换术 屈曲畸形 KSS WOMAC 

分 类 号：R687.4[医药卫生—骨科学]