膝关节术后伸膝迟滞的研究进展  

Progress in extension lag after knee surgery

作　　者：仲憬 杨延砚[1] 张之良 周谋望[1] Zhong Jing;Yang Yanyan;Zhang Zhiliang;Zhou Mouwang(Department of Rehabilitation Medicine,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院康复医学科,北京100191

出　　处：《中华骨科杂志》2023年第16期1123-1128,共6页Chinese Journal of Orthopaedics

摘　　要：多数文献将伸膝迟滞定义为膝关节主动伸直的角度无法达到被动伸直的角度,也有文献将膝关节无法完成最后15°的伸直定义为伸膝迟滞。伸膝迟滞是膝关节术后常见的并发症之一,严重影响患者术后膝关节功能。术后长期制动导致的废用性萎缩、因疼痛和(或)肿胀导致的关节源性肌肉抑制、术中对伸膝装置的直接损伤以及支配股四头肌的神经功能障碍均会造成伸膝迟滞。通过加强康复锻炼、物理因子以及药物治疗可以显著改善伸膝迟滞症状,但因伸膝装置损伤所致的伸膝迟滞必要时需手术治疗。随着手术技术的不断提高、康复介入的不断提前,预防伸膝迟滞的发生、最大程度减少术后伸膝迟滞的角度需引起患者、医生及研究者的足够重视。通过对膝关节术后伸膝迟滞的临床研究进行综述,明确病因、治疗、预防及预后情况,为临床处理提供依据及指导。Most literature defines knee extension lag as the failure of the knee joint to achieve the passive extension angle,and some literature defines the inability of the knee to complete the last 15°extension as knee extension lag.Extension lag is one of the common complications after knee surgery,which seriously affects the postoperative knee joint function of patients.Disuse atrophy due to prolonged postoperative bed rest,arthrogenic muscle inhibition due to pain and(or)swelling,direct injury to the knee extensor mechanism during surgery and nerve dysfunction of the quadriceps muscle can all contribute to extension lag.While rehabilitation exercises,physical therapy and medication can significantly improve the patient's symptoms,extension lag due to the knee extension device injury requires surgery if necessary to regain normal knee function.As surgical techniques continue to be refined and rehabilitation interventions advance,the prevention of extension lag and the minimization of angle of knee extension lag need to be given adequate attention by patients,physicians,and researchers.This article reviews clinical studies related to extension lag after knee surgery,focusing on etiology,treatment,prevention and prognosis,with the aim of providing a basis and guidance for the current clinical management.

关 键 词：膝关节 手术后并发症 伸膝迟滞 

分 类 号：R687.4[医药卫生—骨科学]