膝关节置换治疗膝关节伸直位强直13例  

Total knee arthroplasty for extension ankylosis of the knee: an analysis of 13 cases

作　　者：张有伟[1] 郭礼跃[2] 

机构地区：[1]贵阳中医学院,贵州贵阳550002 [2]贵阳中医学院第二附属医院,贵州贵阳550002

出　　处：《黔南民族医专学报》2015年第1期28-31,共4页Journal of Qiannan Medical College for Nationalities

摘　　要：目的：探讨膝关节置换治疗膝关节伸直位强直的方法和疗效。方法：2008年3月至2014年2月，笔者采用膝关节置换治疗膝关节伸直位强直患者13例，男6例，女7例，平均年龄41.4岁（36.0～63.0岁），其中类风湿性关节炎3例，膝关节周围创伤10例；术前膝关节活动度（0±0）°，HSS评分（38±13.80）分，膝关节功能Lysholm评分（15±13.29）分。结果：全部病例行膝关节置换，平均随访48.7月（9.0～78.0月），末次随访时膝关节活动度（96±12.17）°，HSS 评分（85±7.15）分，膝关节功能Ly-sholm评分（82±6.94）分，手术前后对比统计学有非常显著差异。术后出现髌骨下极撕脱性骨折1例，髌韧带胫骨结节止点部分撕脱1例，切口皮缘部分坏死2例，切口浅表感染1例，经治疗后痊愈，3例分别存在5°、10°、15°伸膝滞缺。结论：膝关节置换治疗膝关节伸直位强直疗效满意，但手术难度大，术后并发症发生率高，且康复训炼至关重要。Objective：To investigate the treatment method and curative effect of total knee arthroplasty for extension ankylosis of the knee. Methods：Total knee arthroplasty was performed to 13 patients with extension anky-losis of the knee from March 2008 to February 2014,including 6 male and 7 female patients with an average age of 41.4 years（36.0 -63.0 years）,among whom 3 patients had rheumatoid arthritis and 10 patients had trauma around the knee joint. Before surgery,the range of motion was （0 ±0）°,the score of HSS and the Lysholm function score were（38 ±13.80）points and （15 ±13.29）points. Results：All of the 13 patients received total knee arthroplasty.The average follow-up was 48.7 months （9.0 -78.0 months）. In the last follow-up,the range of motion was （96 ±12.17）°,the score of HSS and the Lysholm function score were （85 ±7.15）points and （82 ±6.94）points, indicating there were statistically significant differences before and after operation. The postoperative complications included patellar fracture in 1 patient,patellar tendon avulsion in 1 patient,part of incision necrosis in 2 patients and superficial infection in 1 patient. They were all cured after treatment,however,extension lag occurred in 3 pa-tients with degrees of 5°,10°and 15°respectively.Conclusion：Total knee arthroplasty for extension ankylosis of the knee can achieve satisfactory clinical results,but the operation is difficult and the chance of complications is high, and rehabilitation exercise is very important.

关 键 词：全膝关节置换术 关节强直 伸直位 膝关节 

分 类 号：R687.4[医药卫生—骨科学]