人工全膝关节置换术治疗骨性与类风湿性关节炎的中远期疗效与生存分析  

The Mid-and Long-term Efficacy and Survival Rate of Primary Total Knee Arthroplasty in Treatment of End-stage Knee Osteoarthritis and Rheumatoid Arthritis

作　　者：罗文 田小平 徐刚 杨小春[1,2] 金群华[1,3] LUO Wen;TIAN Xiaoping;XU Gang;YANG Xiaochun;JIN Qunhua(Ningxia Medical University,Yinchuan 750004,China;Department of Orthopedic Surgery,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学总医院脊柱骨科,银川750004 [3]宁夏医科大学总医院骨三科,银川750004

出　　处：《宁夏医科大学学报》2021年第8期829-835,共7页Journal of Ningxia Medical University

摘　　要：目的评估初次人工全膝关节置换术治疗膝关节骨性关节炎与膝关节类风湿性关节炎的中、远期临床疗效及所用膝关节假体的生存情况。方法收集因膝关节骨性关节炎或者类风湿性关节炎行初次人工全膝关节置换术的453例(642膝)患者的临床资料。随访7~12年后,比较术前和末次随访时患者的膝关节活动度(ROM)、美国特种外科医院膝关节评分(HSS)、美国膝关节协会评分(AKS)。末次随访时收集翻修患者数量及翻修原因,评估患者满意度。结果322例(464膝)获得随访,随访率为71.1%。末次随访时患者膝关节ROM、HSS评分、AKS评分均高于术前(P均<0.01)。以任何原因导致膝关节假体翻修作为终点事件,计算出464膝所用假体9年生存率为97.4%,397膝史赛克公司Scorpio后稳定假体的9年生存率为97.8%;67膝美国捷迈公司NexGen LPS-FLEX假体的平均11年生存率为94.0%。患者的治疗满意率为95.7%。结论初次人工全膝关节置换术治疗膝关节骨性关节炎与类风湿性关节炎具有良好的中、远期临床疗效,患者满意度高,中远期假体生存率令人满意。Objective To evaluate the mid-and long-term clinical efficacy and prosthetic survival rate of primary total knee arthroplasty for knee osteoarthritis and rheumatoid arthritis.Methods The clinical data of 453 patients(642 knees)who underwent primary total knee arthroplasty due to knee osteoarthritis or rheumatoid arthritis were collected.Knee range of motion(ROM),American Hospital for Special Surgery knee score(HSS),and American Knee Association Score(AKS)were compared between preoperative and final follow-up at 7 to 12 years.At the last follow-up,the number of revision patients and the reasons for revision were collected,and patient satisfaction was evaluated.Results Three hundred and twenty two patients(464 knees)(71.1%)were followed up.At the last follow-up,the knee ROM,HSS and AKS scores were all higher than those before surgery(P all<0.01).When the knee joint prosthesis was revised for any reason as the end point of follow-up,the 9-year survival rate of the 464 knee prosthesis was 97.4%,the 9-year survival rate of the 397 knee Scorpio posterior-stabilized prosthesis was 97.8%;and the average 11-year survival rate of the 67 knee Zimmer NexGen LPS-FLEX prosthesis was 94.0%.The treatment satisfaction rate of the patients was 95.7%.Conclusion The mid-and long-term study indicates that primary TKA shows favorable clinical and radiological outcomes for knee osteoarthritis and knee rheumatoid arthritis and the survival rate is satisfactory.

关 键 词：人工关节置换术 膝关节 生存分析 随访研究 

分 类 号：R684.3[医药卫生—骨科学]