全膝关节置换术在重度血友病性关节炎的疗效分析  

Clinical effect of total knee arthroplasty in treatment of severe hemophilic arthritis cases

作　　者：尚宏喜[1] 贺敬龙 郝敏[1] 丁强[1] 孙炜[1] 刘安庆[1] 谢伟[1] Shang Hongxi;He Jinglong;Hao Min;Ding Qiang;Sun Wei;Liu Anqing;Xie Wei(Department of Joint Surgery, the Second People’s Hospital of Shenzhen(the First Affiliated Hospital of Shenzhen University), Shenzhen 518037, China)

机构地区：[1]深圳市第二人民医院,518037

出　　处：《中华关节外科杂志（电子版）》2021年第6期753-757,共5页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨全膝关节置换术在重度血友病性膝关节炎的临床治疗效果。方法选取2013年10月至2019年12月间深圳市第二人民医院骨关节科收治的血友病性膝关节炎并行全膝关节置换术的病例6例(6膝),患者均为男性。对其膝关节活动度、畸形程度及功能评分等数据用t检验分析。结果所有患者治疗过程顺利,未出现关节脱位、松动、感染、骨折等并发症,膝关节的屈曲或外翻畸形予以纠正。经过平均(48±21)个月随访,膝关节活动度由术前的为(34±29)°提高到术后的(96±18)°(t=-8.357,P<0.001);膝关节外翻畸形程度由术前的(14.3±3.4)°降低到术后的(3.7±2.2)°(t=7.854,P<0.001);膝关节HSS评分也由术前的(34±13)分提高到术后的(89±6)分(t=-9.294,P<0.001)。结论全膝关节置换术应用于血友病性关节炎可明显增加膝关节活动度,改善膝关节功能,矫正膝关节畸形,提高患者的生活质量,是治疗膝关节疾患的有效方法。Objective To evaluate the clinical efficacy of total knee arthroplasty(TKA)in treating the knee joint involvement of hemophilia.Methods Six cases(six knees),all of whom were male,were selected who suffered hemophilic knee arthritis and underwent TKA in the department of joint surgery of the Second People′s Hospital of Shenzhen from October 2013 to December 2019.The range of motion(ROM),malformation of knee,as well as functional recovery were analyzed by t test.Results All the patients had satisfactory treatment effect with their knee flexion or valgus rectified.No postoperative joint dislocation,loosening,infection,fracture or other complications were found.After the follow-up of(48±21)months in average,ROM of knee increased from(34±29)°before operation to(96±18)°after operation(t=-8.357,P<0.001);the degree of knee valgus deformity decreased from(14.3±3.4)°to(3.7±2.2)°,and the difference was statistically significant(t=7.854,P<0.001);the knee score of Hospital for Special Surgery(HSS)increased from(34±13)to(89±6)(t=-9.294,P<0.001).Conclusion The application of TKA is an effective method for the treatment of hemophilic arthritis,which can significantly increase knee ROM,improve the function of knee,correct knee deformity,and improve the quality of life of patients.

关 键 词：关节成形术 置换 膝 血友病A 血友病B 关节炎 

分 类 号：R68[医药卫生—骨科学]