老年患者全膝关节置换术后疗效分析  

Clinical Results of the Total Knee Arthoplasty in the Aged

作　　者：汪更胜[1] 朱新林[1] 殷丹 FANG Geng-sheng;ZHU Xin-lin;YTN Dan(Ho.163 Hospital of PLA,Second Affiliated Hospital of Hunan Normal University,Changsha 410003,Hunan,China)

机构地区：[1]解放军第163医院湖南师范大学第二附属医院,长沙410003

出　　处：《中国现代手术学杂志》2018年第2期142-144,共3页Chinese Journal of Modern Operative Surgery

基　　金：湖南省教育厅项目(16C0969)

摘　　要：目的分析老年患者全膝关节置换术(total knee arthoplasty,TKA)的术后疗效。方法回顾性总结我科2008年10月~2017年10月完成的110例TKA病例资料,全部病例均测量术前及术后1周、术后6个月的HSS膝关节评分、膝关节活动度、大腿周径和小腿周径等。结果全部110例患者均顺利完成手术,未出现明显并发症。术后1周,膝关节活动度由术前86.54°±17.93°改善到术后107.20°±11.41°,HSS评分由术前(50.48±8.40)分改善到术后(90.60±3.61)分;2个时间点比较差异显著(P<0.05);术后6个月,膝关节活动度及HSS稍有下降,但与术前比较仍有显著差异(P<0.05),而与术后1周比较无明显差异(P>0.05)。术后1周患者的大、小腿周径有明显肿胀,但6个月后恢复,与术前比较无明显差异(P>0.05)。膝关节功能评分优95例,良5例,可10例,优良率90.1%。结论膝关节置换的关键在术前对病例正确的选择,手术指针的把握,术中正确的截骨和软组织平衡。Objective To analyze the postoperative outcomes of total knee arthroplasty（ TKA） in elderly patients. Methods A retrospective review of 110 TKA cases completed in our department from October 2008 to October 2017 were conducted. Results All 110 patients successfully completed the operation without obvious complications. One weeks after operation,the knee joint activity improved from6. 54° ± 17. 93° to 107. 20° ± 11. 41°,and the HSS score improved from 50. 48 ± 8. 40 to 90. 60 ± 3. 61,which were significantly higher than the pre-operative ones（ P〈0. 05）. Although the knee joint activity and HSS decreased slightly after 6 months,but there were still higher than before the pre-operative ones（ P〈0. 05）. The knee function score was excellent in 95 cases,good in 5 cases,fair in 10 cases,and the excellent and good rate was 90. 1%. Conclusion The key to TRA is correct selection of cases before operation,proper grasp of operative pointers,correct osteotomy and soft tissue balance during operation.

关 键 词：全膝关节置换术 膝关节炎 老年人 

分 类 号：R687.4[医药卫生—骨科学] R684.3[医药卫生—外科学]