人工全膝关节置换术治疗类风湿性关节炎短期临床疗效研究  

Short-term clinical effect of total knee arthroplasty in patients with rheumatoid arthritis

作　　者：李勇[1] 刘志斌[1] 段永宏[2] 杜璠[1] 

机构地区：[1]延安大学附属医院骨科二病区,延安716000 [2]第四军医大学西京医院急诊中心

出　　处：《陕西医学杂志》2014年第11期1470-1474,共5页Shaanxi Medical Journal

摘　　要：目的：观察人工全膝关节置换术（TKA）治疗类风湿性关节炎短期临床疗效。方法：对36例（47膝）类风湿关节炎（RA）患者施行TKA，采用HSS评分对患者术前术后膝关节功能进行评估，同时对术后的影像学资料进行评价，采用SF‐36健康量表对患者术前术后的生活质量进行评估，采用满意度量表对TKA后患者满意度进行对比。结果：31例（40膝）获得平均（3．65±0．95）年（2～5年）随访，膝关节HSS评分由术前平均（44．89±13．95）分提高到术后平均（88．46±5．97）分，手术前后比较差异有统计学意义，其中优秀26膝，良好11膝，可2膝，差1膝，优良率92．50％；膝关节活动度由术前（70．05±25．71）°提高到术后（97．26±15．29）°，术前、术后的ROM比较差异有显著意义；膝关节内外翻畸形、屈曲挛缩畸形状况也得到改善。膝关节假体采用膝关节学会X线评价与计分系统评价未见假体松动。患者术后SF‐36评分各评分均较术前得到明显改善，其中PCS术前平均（27．48±4．59）分，提高至术后平均（47．68±6．98）分，手术前后比较差异有统计学意义；MCS术前平均（42．46±5．63）分，提高至术后平均（53．99±5．74）分，手术前后比较差异有统计学意义。患者TKA后随访满意度满意率90％。结论：TKA治疗类风湿性关节炎短期临床疗效良好，患者生活质量得到明显提高，且满意度高。objective ：To observe the short‐term clinical effect of total knee arthroplasty （TKA） in pa‐tients with Rheumatoid Arthritis （RA） .Methods ：The clinical results of 36 patients （47 knees） were evaluated by using HSS scoring system .The patients’ health statuses were evaluated by using the Short Form 36‐item Survey （SF‐36） .The patients’ satisfaction scores were evaluated by using the British Orthopaedic Association patient‐satis‐faction score .The postoperative X‐ray imaging data were analyzed at the last follow‐up .Results ：31 patients （40 knees） obtained an average follow‐up of 3 .65 years （from 2 to 5 years） .All functions of knee joint improved after TKA .The mean value of the scores according to HSS was average improved from the preoperative （44 .89 ± 13 .95） to the （88 .46 ± 5 .97） at the follow‐up examination ,with 26 cases rated as excellent and 11 as good （excellent or good results rate of 92 .50% ） .The serious flexion deformities of the involved knees had been corrected .The average ranges of motion improved from the preoperative （70 .05 ± 25 .71）°to the （97 .26 ± 15 .29）°at the follow‐up .No loos‐ening happened according to The Knee Society total knee arthroplasty roentgen graphic evaluation and scoring sys‐tem .The mean value of the scores based on the SF‐36 scores PCS showed an average improvement from （27 .48 ± 4 . 59） preoperatively to （47 .68 ± 6 .98） at follow‐up .The MCS showed an average improvement from （42 .46 ± 5 .63） preoperatively to （53 .99 ± 5 .74） at follow‐up .The very satisfactory or satisfactory results rate of 90% .Conclusion ：The short‐term of clinical effect of TKA in patients with RA is satisfactory ,which also can be used to improve the patients’ quality of life .

关 键 词：关节成形术 置换  膝/方法 关节炎  类风湿/外科学 @HSS评分 随访研究 

分 类 号：R684.3[医药卫生—骨科学]