双膝骨性关节炎患者未行二期膝关节置换的影响因素  

Impact factors for the bilateral knee osteoarthritis patients without total knee arthroplasty at second stage

作　　者：加亨[1] 梁治权[1] 方锐[1] 邓迎杰[1] 孟庆才[1] 

机构地区：[1]新疆医科大学第四附属医院关节外科,新疆维吾尔自治区乌鲁木齐市830000

出　　处：《中国组织工程研究》2012年第52期9707-9711,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:双膝骨性关节炎患者,做单侧置换后,很大一部分患者未作二次对侧置换,有很多影响因素。目的:双膝骨性关节炎患者一期选择性单侧全膝关节置换后未行二期对侧膝关节置换的影响因素分析。方法:纳入初次一期单侧全膝关节置换的双膝骨性关节炎患者28例28膝,假体均采用施乐辉公司普通型,所有患者一期单侧全膝关节置换后1年内未行二期对侧膝关节置换。记录置换前后HSS评分、膝关节活动范围;同时对28例患者未行二期膝关节置换影响因素进行问卷调查。结果与结论:2例失访,2例在外院行对侧膝关节置换,最终随访24例24膝,平均随访12.6个月(12-19个月)。膝关节活动范围与HSS评分置换后与置换前比较均显著增加,差异有显著性意义(P=0.007,P=0.409)。问卷调查分析影响患者选择二期手术因素,单因素随访结果围手术期疼痛是主因占到95%以上;多因素随访结果:围手术期的疼痛占95.8%,心理因素占87.5%,医院的软件条件占70.8%,3项原因平均占总因素的84.7%。说明24例24膝未行二期膝关节置换影响因素中置换后围手术期的疼痛、患者的心理因素及医院的软件条件占据主导地位。BACKGROUND： Most of the patients with bilateral knee osteoarthritis will not receive the contralateral total knee arthroplasty due to many factors. OBJECTIVE： To analyze the factors for the bilateral knee osteoarthritis patients undergoing a selective unilateral total knee arthroplasty without contralateral knee arthroplasty at second stage. METHODS： A toal of 28 bilateral knee osteoarthritis patients （28 knees） treated with unilateral total knee arthroplasty were included, the prostheses were the Smith Nephew ordinary type. All the patients did not receive the second stage contralateral knee arthroplasty within 1 year after unilateral total knee arthroplasty. The HSS score and range of motion of knee were recorded before and after replacement; at the same time, the 28 patients that did not receive the second stage contralateral knee arthroplasty were questionnaired for the factors. RESULTS AND CONCLUSION： Two cases were lost, 2 cases underwent contralateral total knee arthroplasty at the other hospital. And finally, 24 patients （24 knees） received the final follow-up, the average follow-up time was 12.6 months （12 to19 months）. The range of motion and the HSS score after replacement were improved compared with those before replacement, the difference was statistically significant （P=0.007, P=0.409）. Questionnaire survey was performed to analyze the factors for second stage surgery, single factor follow-up results showed that perioperative pain was the main reason that accounting for more than 95%; multivariate follow-up results showed that perioperative pain accounted for 95.8%, psychological factors accounted for 87.5%, conditions of the hospital＇s software accounted for 70.8%; the average of the three reasons accounted for 84.7%. It indicates that perioperative pain, psychological factors and conditions of the hospital＇s software are the dominate reasons for the 24 patients （24 knees） without second stage ontralateral knee arthroplasty.

关 键 词：膝关节 假体 骨性关节炎 置换 影响因素 疼痛 心理因素 问卷调查 膝关节活动范围 HSS评分 

分 类 号：R318[医药卫生—生物医学工程]