全膝关节置换术治疗膝关节僵硬的疗效分析  

Analysis of the Clinical Effect of Total Knee Arthroplastyin Stiff Knees

作　　者：肖世卓 郑秋 李宇 曾亚兰 王立志 杨洪彬 Xiao Shizhuo;Zhen Qiu;Li Yu(Department of Bone and Joint Surgery,Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院骨与关节外科

出　　处：《实用骨科杂志》2019年第12期1073-1076,1084,共5页Journal of Practical Orthopaedics

基　　金：四川省科技厅科研基金资助项目(2013JY0103)

摘　　要：目的分析并比较膝关节僵硬患者行全膝关节置换术(total knee arthroplasty,TKA)后的临床疗效。方法分析2012年5月至2017年4月19例(23膝)行TKA治疗的膝关节僵硬患者,其中男7例,女12例;年龄48~79岁,平均(63.63±7.75)岁。4例患者双侧均为僵硬膝,在随访时间内分2次行双膝TKA治疗,间隔时间6~12个月。观察并比较各膝术前、术后半年及术后2年的美国膝关节协会评分(the American knee society score,AKS)及关节活动度(range of motion,ROM)。结果19例患者均获得随访,分两次随访全部膝关节术后半年、术后2年的AKS及ROM。关节活动范围:术前10°~47°,平均(31.17±9.63)°;术后半年55°~115°,平均(93.04±14.83)°;术后2年35°~110°,平均(85.00±19.83)°;患者术前与术后比较差异具有统计学意义(P<0.05),术后半年至术后2年关节活动范围均有所减小(P<0.05)。AKS评分:术前12.00~69.00分,平均(33.17±12.32)分;术后半年53.00~99.00分,平均(74.44±12.72)分;术后2年52.00~96.00分,平均(70.57±13.24)分;术后AKS评分较术前显著提高,差异具有统计学意义(P<0.05),术后半年与术后2年AKS评分差异无统计学意义(P>0.05)。结论人工TKA能显著改善膝关节僵硬患者的运动功能及生活质量。Objective To analyze and compare the clinical effect of total knee arthroplasty(TKA)for patients with knee stiffness.Methods Nineteen patients(23 knees)were retrospectively analyzed after total knee arthroplasty from May 2012 to April 2017,including 7 males and 12 females.The age ranges from 48 to 79,with an average age of(63.63±7.75).The follow-up results were divided into three groups before operation,six months after operation and two years after operation and compared with each other.Clinical evaluation was performed using American Knee Society Knee(AKS)Score and range of motion(ROM).Results All 19 patients were followed up,and AKS and ROM were followed up for 6 months and 2 years after TKA.The range of motion increased from(31.17±9.63)°(range:10°to 47°)before surgery to(93.04±14.83)°(range:55°to 115°)six months after surgery,and(85.00±19.83)°(range:35°to 110°)two years after surgery.The difference between preoperative and postoperative activities was significant(P<0.05).The range of joint motion decreased from six months to two years after surgery(P<0.05).AKS scores were(33.17±12.32)(range:12 to 69)before surgery,(74.44±12.72)(range:53 to 99)six months after surgery,and(70.57±13.24)(range:52 to 96)two years after surgery.There were significant differences between preoperative and postoperative scores(P<0.05),and the AKS scores were significantly improved after the operation compared with that before the operation,but there was no significant difference between six months after the operation and two years after the operation(P>0.05).Conclusion Total knee replacement can significantly improve the motor function and quality of life of patients with knee stiffness.

关 键 词：僵硬膝 关节置换术 临床疗效 手术入路 

分 类 号：R687.42[医药卫生—骨科学]