人工膝关节表面置换术近期疗效观察  

Clinical observation on short-term effects of primary total knee arthroplasty

作　　者：汪群力[1] 陈奇[1] 龚继承[1] 罗伟国[1] 邹重文[1] 杨柏林[1] 

机构地区：[1]解放军第187中心医院骨二科,海南海口571159

出　　处：《局解手术学杂志》2014年第5期516-519,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的：评估膝关节表面置换术的近期疗效，分析主要并发症发生的原因和预防方法。方法回顾分析自2010年1月-2013年12月在我院初次接受膝关节表面置换术的63例70膝患者资料，比较并分析术前和随访时患膝KSS和HSS评分、关节活动度检查等数据。结果通过各个时间段随访及X线检查结果的观察，正位片示膝关节人工假体位置安放好，关节间隙平衡；侧位片示人工关节假体大小合适，胫骨假体后倾角度良好，股骨假体包裹效果好。术后腓总神经麻痹2例，于术后4-6个月逐渐恢复。5例患者术后关节活动度较差，为（0-60±10）°，术后2-3周在强镇痛药物辅助下行手法松解处理；髌前痛1例，术后4个月经关节镜下行髌骨外侧支持带松解术后症状解除。随访时膝关节表面置换术后HSS及KSS评分均较术前显著提高。膝关节活动度从术前的（78.3±18.6）°提高至术后的（109.2±19.9）°（P〈0.O1）。结论初次人工膝关节表面置换术对于消除膝关节疼痛，改善关节的活动功能效果明显，术后近期的并发症发生率低。Objective To evaluate the short-term effects of total knee arthroplasty （ TKA） , and to detect the causes and prevention of major complications. Methods It was a retrospective study since January 2010 to December 2013. There were 63 patients with 70 knees re-ceived primary TKA. KSS knee scores, HSS knee scores, and range of motion （ ROM） before the operation and during the follow-up were as-sessed and analysed. Results According to the results of follow-up and the X-ray observation, the anteroposterior radiographs showed that the artificial prosthesis were placed well and the joint gap were balanced;the lateral radiographs showed that the artificial joint prosthesis we-rer of appropriate size, good tilt angle, and good package effect. There were two cases developed peroneal nerve palsy and they gradually re-stored in 4 to 6 months after surgery. 5 cases were of poor postoperative ROM （0-60 ± 10）°. Strong analgesic medication-assisted release were conducted in 2 to 3 weeks after surgery. 1 case had patellar pain and resorted by arthroscopic lateral ligament of patellar releasing sur-gery. During the follow-up period, TKA significantly improved HSS and KSS scores compared to preoperative scores. ROM was increased from （78. 3 ± 18. 6）° preoperatively to （109. 2 ± 19. 9）° postoperative （P〈0. 01）. Conclusion TKA was effective to release knee pain, improve ROM and reduce the incidence of postoperative complications.

关 键 词：膝关节 置换 并发症 

分 类 号：R684.3[医药卫生—骨科学]