中药外敷联合关节腔内注入玻璃酸钠治疗早期膝骨关节炎临床疗效观察

目的 探讨中药外敷联合关节腔内注入玻璃酸钠治疗早期膝骨关节炎的临床疗效。方法 选取116例早期膝骨关节炎患者,按照随机数字表法分为对照组及观察组各58例,对照组采用关节腔内注入玻璃酸钠治疗,观察组采用中药外敷配合关节腔内注入玻璃酸钠治疗。观察并比较两组膝部疼痛视觉模拟量表（VAS）评分、特种外科医院（HSS）膝关节评分、关节活动度、内翻角、股四头肌肌力以及不良反应发生情况。结果 两组治疗前VAS评分比较差异无统计学意义,治疗后VAS评分均较治疗前降低（P均<0.05）;治疗后,观察组VAS评分低于对照组（P均<0.05）。两组治疗前HSS膝关节评分比较差异无统计学意义,治疗后HSS膝关节评分均较治疗前升高（P均<0.05）;治疗后,观察组HSS膝关节评分高于对照组（P均<0.05）。两组治疗前膝关节活动度、内翻角比较差异无统计学意义;治疗后膝关节活动度均较治疗前升高,内翻角均较治疗前降低（P均<0.05）;治疗后,观察组膝关节活动度高于对照组,内翻角低于对照组（P均<0.05）。两组治疗前膝关节肌力比较差异无统计学意义,治疗后两组膝关节肌力均增强（P...     

鸡尾酒疗法对老年全膝关节置换术后镇痛的影响

目的探究鸡尾酒疗法对老年患者全膝关节置换术的镇痛效果及安全性。方法 2014年1月至2015年6月在该院行单侧全膝关节置换术的老年患者60例分为实验组和对照组各30例,男女比例1∶1。实验组患者膝关节置换完成缝合前在关节腔周围组织注射镇痛药物,对照组不进行相关处理。记录两组患者在术后4、8、12、24、48 h各时间点静止及运动视觉模拟疼痛评分(VAS),术后首次下床时间及静脉自控镇痛(PCIA)首次按压与术毕时间差,PCIA按压次数,患者镇痛满意度及不良反应发生情况。结果实验组患者术后8、12、24 h时间点静息及运动VAS疼痛评分显著低于对照组(P0.05);实验组患者PCIA首次自控追加药物时间显著晚于对照组,术后镇痛泵按压次数显著低于对照组,镇痛满意度显著高于对照组(P0.05)。结论关节周围注射镇痛药物与PCIA联合应用于老年患者全膝关节置换术后镇痛可显著降低患者术后静息和运动VAS疼痛评分,降低术后阿片类镇痛药物的用量,有利于患者术后早期功能康复训练和功能重建,是一种安全有效的治疗方法。     

同期或分期全膝关节置换术治疗高龄双膝关节骨关节炎的疗效

目的探讨同期或分期全膝关节置换术(TKA)治疗高龄双侧膝关节骨关节炎(KOA)的疗效。方法 TKA手术治疗的KOA高龄患者122例,根据患者接受的治疗方案进行分组,同次麻醉情况下进行同期双侧TKA治疗组(同期双侧组)55例,相同住院周期内进行分次双侧TKA治疗组(分次双侧组)27例,不同住院周期条件进行的分期双侧TKA治疗组(分期双侧组)40例。对比各组患者的手术相关指标,术前及术后6个月对各组美国特种外科医院(HSS)膝关节评分、西安大略和麦克马斯特大学(WOMAC)骨关节炎指数进行评定,记录各组并发症。结果分次双侧组及分期双侧组的手术时间和住院时间以及住院费用均分别明显大于同期双侧组,但输血量以及术后引流量均明显少于同期双侧组(均P<0.05)。各组患者术前及术后6个月的关节功能评分对比(P>0.05)。分次双侧组及分期双侧组的并发症总发生率,均明显低于同期双侧组(P<0.05)。结论分期或分次TKA治疗高龄双膝KOA患者的疗效与同期TKA基本类似,但同期TKA术式通常并发症发生率更高,值得临床重视。     

单髁膝置换术与全膝关节置换术治疗膝关节内侧间室骨关节炎的近期疗效比较

目的探讨单髁膝置换术(UKA)与全膝关节置换术(TKA)治疗膝关节内侧间室骨关节炎的近期疗效。方法回顾性分析2017-01～2017-10对因膝关节内侧间室骨关节炎行UKA治疗患者15例(15膝),选取同期行TKA治疗患者30例(34膝)作为对照组。术前评估并记录两组患者的疼痛视觉模拟评分(VAS)、美国特种外科医院(HSS)评分、膝关节活动度(ROM),记录手术时间、术中出血量、术后3 d血红蛋白(Hb)下降量、术后3个月及1年VAS评分、HSS评分、ROM。结果所有患者手术顺利完成。两组患者年龄、体重指数(BMI)比较差异无统计学意义(P0.05)。UKA组手术时间、术中出血量、术后3 d Hb下降量、VAS评分均低于TKA组,而HSS评分、ROM高于TKA组,差异均有统计学意义(P0.05)。结论膝关节内侧间室骨关节炎的手术治疗选择UKA更优于TKA,UKA具有手术时间短、术中出血量少、术后恢复快、功能恢复良好等优点,能够取得良好的近期疗效。     

基于活动平板训练的虚拟现实技术在全膝关节表面置换术患者中的应用

目的探讨基于活动平板训练的虚拟现实技术(Virtual reality,VR)在全膝关节表面置换术(Total knee arthroplasty,TKA)患者中的应用。方法将我院关节外科行单侧TKA术后的62例患者随机均分为观察组(31例)和对照组(31例)。两组患者术后均接受常规的康复训练,观察组在此基础上进行基于活动平板训练的VR训练。对比两组患者术后VAS疼痛评分、膝关节肿胀程度及主动活动度、美国特种外科医院膝关节功能评分(HSS)以及临床疗效。结果两组术后3d、5d、7d VAS评分及术后5d、7d膝关节肿胀度差异具有统计学意义(P0.05);但术后第3d两组膝关节肿胀度差异无统计学意义(P0.05);观察组术后2周、6周膝关节主动活动度显著高于对照组(P0.05),两组术前及术后3个月、6个月膝关节主动活动度差异无统计学意义(P0.05)。两组患者术前HSS评分差异无统计学意义(P0.05),术后1周、2周、6周及3个月两组差异具有统计学意义(P0.05)。观察组患者优良率明显高于对照组,差异具有统计学意义(P0.05)。结论基于活动平板训练的VR技术可以有效的缓解TKA术后早期康复的疼痛、减轻膝关节的肿胀,提高术后膝关节的功能。     

人工全膝关节置换术治疗膝关节骨关节炎的疗效观察

目的 观察人工全膝关节置换术（TKA）治疗膝关节骨性关节炎（KOA）的临床疗效.方法 选择120例（140膝）DOA患者,均行后稳定型人工全膝关节置换术（TKA）治疗,术后应用抗生素并加强关节功能锻炼,应用膝关节功能（HSS）评分系统判定疗效.结果 术后对患者平均随访18个月,膝关节功能优良率为92.5％;HSS评分由（40±5.56）分升至（95±7.68）分,关节活动度由平均60°提高至平均95°,P均＜0.05.结论 TKA治疗KOA疗效确切,严格手术指征、术中矫正畸形时保持膝关节内外侧间隙及周围软组织平衡是手术成功的关键.     

去神经化治疗膝关节置换术后膝关节顽固性疼痛的临床效果

目的探讨去神经化治疗全膝关节置换术(TKA)后膝关节顽固性疼痛患者的临床疗效。方法选取该院骨科应用TKA治疗后出现膝关节顽固性疼痛的21例患者作为观察组,均采取去神经化治疗,选取同期应用镇痛药物治疗的19例患者作为对照组,在治疗前、治疗后1 w、4 w和6个月时,应用健康生存评分(HSS)量表和视觉模拟疼痛(VAS)评分表评估患者的疼痛程度和膝关节功能,同时评估膝关节的活动度(ROM)。结果与治疗前比较,观察组HSS、VAS评分改善和患肢ROM得到显著缓解,对照组VAS评分改善明显(均P<0.05),但是HSS和患肢ROM未见明显改善(P>0.05)。治疗后,观察组HSS和患肢ROM显著优于对照组(P<0.05)。结论去神经化治疗能够有效减轻TKA后膝关节顽固性疼痛患者的疼痛程度,明显改善患肢ROM和功能。     

基于虚拟现实技术的康复方法对TKA术后早期功能锻炼的临床研究

目的探讨基于虚拟现实(VR)技术的康复方法在全膝关节置换术(TKA)后早期功能恢复及关节功能的影响。方法选取2015年3月-2016年10月在我院关节外科行TKA治疗的50例患者作为研究对象。按照随机数表法随机分为试验组(23例)和对照组(27例)。试验组术后采用虚拟现实技术(VR)康复锻炼,对照组术后采用持续性被动活动(CPM)进行功能锻炼,术后随访比较两组患者在术后VAS疼痛评分、膝关节肿胀程度、膝关节活动度、膝关节功能评分(HSS)、Berg平衡量表评分(BBS)、膝关节本体感觉评分。结果 (1)两组患者在术后3d、5d、7d VAS评分及术后5d、7d肿胀度差异具有统计学意义(P0.05);(2)两组患者在术后2周、6周膝关节主被动活动度上试验组明显要高于对照组(P0.05);(3)两组患者术后2周、6周及3个月HSS评分差异均具有统计学意义(P0.05);(4)两组患者发现术后1周、2周、6周及3个月试验组BBS评分均显著优于对照组水平(P0.05);(5)术前、术后1周、2周、6周及3个月两组患者膝关节本体感觉评分差异均无统计学意义(P0.05)。结论基于虚拟现实技术的康复锻炼可以有效的缓解TKA术后疼痛及肿胀程度,同时还可以促进膝关节功能的恢复,但是对膝关节本体感觉的改善无明显优势。     

股内侧肌下入路与髌旁内侧入路行TKA治疗膝关节骨性关节炎对比观察

目的 比较股内侧肌下入路（SVA）与髌旁内侧入路（MPA）行全膝关节置换术（TKA）治疗膝关节骨性关节炎（KOA）的临床效果。方法 选择KOA患者89例,其中经SVA行TKA 46例（SVA组）、经MPA行TKA 43例（MPA组）。比较两组术前及术后1、3、6个月视觉模拟评分（VAS）、膝关节活动度（ROM）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分及Berg平衡量表（BBS）评分,手术前后股骨与胫骨机械轴夹角（mFTA）,术前及术后6个月起立-行走计时（TUG）测试、被动活动察觉阈值（TDPM）以及患膝术后初次主动直腿抬高（SLR）时间。结果 术后1、3、6个月,两组VAS、ROM、WOMAC评分和BBS评分（除MPA组术后1个月BBS评分外）均较术前显著改善（P均<0.05）;除术后6个月BBS评分外,SVA组术后各时间VAS、ROM、WOMAC评分和BBS评分均优于MPA组同期（P均<0.05）。两组术后6个月mFTA、TUG测试、TDPM均显著低于术前（P均<0.05）,且SVA组术后6个月TUG测试、TDPM优于MPA组（P均<0.05...     

膝关节周围罗哌卡因联合氟比洛芬酯多点注射对老年患者膝关节镜术后加速康复的影响

目的探讨膝关节镜术后罗哌卡因联合氟比洛芬酯膝关节周围多点注射对老年患者加速康复的影响。方法选择择期行膝关节镜下手术患者60例,随机分为对照组和实验组,每组30例。对照组在手术结束后予以静脉芬太尼镇痛泵止痛,实验组予以罗哌卡因+氟比洛芬酯膝关节周围7个部位进行注射止痛。分别于术前1 d,术后4、8、12、24、48、72 h比较两组在膝关节静息状态下和运动后的视觉模拟评分法(VAS)评分;记录两组术后肠蠕动恢复时间、下床活动时间及住院天数;比较两组术后不良反应发生率及整体满意率;利用失眠严重程度量表(ISS)评估并比较两组手术当天及第2天睡眠质量情况。结果术前两组膝关节静息状态下和运动后VAS评分差异无统计学意义(P>0.05)。实验组术后8、12、24、48、72 h膝关节静息状态下和运动后的VAS评分均显著低于对照组(P<0.05)。两组术后恶心呕吐、头晕头痛、呼吸抑制和下肢麻木单项的发生率差异无统计学意义(P>0.05),而实验组整体并发症发生率显著低于对照组(P=0.01)。实验组术后当日、术后第1天ISS评分及肠蠕动恢复时间、术后下床活动时间、住院天数均显著低于对照组(P<0.05)。实验组满意度显著高于对照组(P=0.04)。结论老年患者膝关节镜术后膝关节周围罗哌卡因联合氟比洛芬酯多点注射较静脉芬太尼镇痛泵更有助于减轻术后疼痛,有助于早期康复和改善睡眠质量。     

Total knee arthroplasty on the disease activity of rheumatoid arthritis

The effects of total knee arthroplasty (TKA) on the disease activity of rheumatoid arthritis (RA) was investigated in the present study. The disease activity of RA in 58 patients who had undergone simultaneous bilateral TKA (116 knee joints) was examined before, and 1, 6 and 12 months and 3 and 5 years after the operation. The disease activity was assessed using the simplified Lansbury index according to the duration of morning stiffness, grip strength, joint count and erythrocyte sedimentation rate. In addition, C-reactive protein (CRP) and rheumatoid factor were also measured. The mean simplified Lansbury index and CRP significantly improved 1, 6 and 12 months after TKA surgery compared to preoperative levels. However, 3 and 5 years after TKA, the mean simplified Lansbury index indicated that the disease activity remained lower than the preoperative level in only 21 (36%) patients. The results of the present study demonstrate that TKA lowers RA activity for at least 1 year after surgery, and thus synovectomy and surgical resection of articular cartilage in the knee joint appear to have an anti-rheumatoid effect.     

Total knee arthroplasty on the disease activity of rheumatoid arthritis

Abstract

The effects of total knee arthroplasty (TKA) on the disease activity of rheumatoid arthritis (RA) was investigated in the present study. The disease activity of RA in 58 patients who had undergone simultaneous bilateral TKA (116 knee joints) was examined before, and 1, 6 and 12 months and 3 and 5 years after the operation. The disease activity was assessed using the simplified Lansbury index according to the duration of morning stiffness, grip strength, joint count and erythrocyte sedimentation rate. In addition, C-reactive protein (CRP) and rheumatoid factor were also measured. The mean simplified Lansbury index and CRP significantly improved 1, 6 and 12 months after TKA surgery compared to preoperative levels. However, 3 and 5 years after TKA, the mean simplified Lansbury index indicated that the disease activity remained lower than the preoperative level in only 21 (36%) patients. The results of the present study demonstrate that TKA lowers RA activity for at least 1 year after surgery, and thus synovectomy and surgical resection of articular cartilage in the knee joint appear to have an anti-rheumatoid effect.     

Preliminary results of integrated therapy for patients with knee osteoarthritis

OBJECTIVE: To investigate the effects of integrated therapy on the functional status of patients with knee osteoarthritis (OA). METHODS: A total of 140 subjects with bilateral knee OA (Altman grade II) were randomized sequentially into 4 groups (groups I-IV). Group I received isokinetic exercises; group II received isokinetic exercise and pulse ultrasound for periarticular soft tissue pain; group III received isokinetic exercise, pulse ultrasound, and intraarticular hyaluronan therapy; and group IV acted as the control group. The therapeutic effects of the interventions were evaluated by changes in Lequesne's index, knee range of motion, peak muscle torques of knee flexion and extension, and ambulation speed after 8 weeks of treatment and at followup 1 year later. In addition, changes in visual analog scale pain and rates of attrition in each group were also recorded. RESULTS: Patients in groups I-III exhibited increased muscle peak torques and significantly reduced pain and disability after treatment and at followup. Groups II and III showed significant improvements in range of motion and ambulation speed after treatment. Group III also showed the greatest increase in walking speed and decrease in disability after treatment and at followup. Both group II and group III had significant gains in muscular strength after treatment and at followup; group III showed the greatest gains. CONCLUSION: An integrated therapy deals with the extra- and intraarticular progressive pathologic changes, and kinesiologic management of OA is suggested for the management of knee OA.     

Prolonged prophylaxis in orthopedic surgery: insights from the United States

The U.S. Hip and Knee Registry is a voluntary national registry of outcome data for hip and knee surgery. In total, 469 orthopedic surgeons from 325 hospitals reported data on 7677 patients who underwent total hip arthroplasty (THA) and 11,461 patients who underwent total knee arthroplasty (TKA). Data on patients enrolled between 1996 and 2000 indicate that 40% of THA patients and 42% of TKA patients received prophylaxis for a period of 8 to 21 days, including the in-hospital period. Prolonged prophylaxis for more than 21 days was used in 49% of THA patients and 44% of TKA patients. Moreover, year on year, data indicate that the percentage of patients who receive prophylaxis for longer than 21 days is gradually increasing. In 2000, 53% of THA patients and 47% of TKA patients received prophylaxis for longer than 21 days.     

人促红素减少老年全膝关节置换术后输血的临床对照研究

目的探讨控制老年患者人工全膝关节置换术（TKA）手术出血量、减少术后同种输血需要量,降低患者输血率的方法。方法选取60例拟行TKA的老年病人,随机分成3组：试验组20例,术后不引流,采用围手术期静注重组人促红素;对照组20例,术后不予引流;常规手术组20例,术后常规留置引流管。比较3组术前、术后1 d、7 d、2周时血红蛋白（Hb）、红细胞比积（Hct）,以及术后并发症和膝关节功能康复情况。实际失血量等于通过手术前后Hct变化计算的理论值加上额外的输血量和自体回输血量。通过观察输血量、用差值来比较术前和术后各观察时间点的Hb动态变化,来评估患者术后同种输血需要量是否减少。结果术后3组切口均Ⅰ期愈合。随访时间12~22月。常规引流组较试验组和对照组术后出血量明显增加;试验组术后Hb减少最少;3组术后膝关节功能无明显差异。结论术后不引流加静注重组人促红素是控制TKA手术出血量、减少术后同种输血需要量的有效方法之一。     

The effects of total knee arthroplasty on physical functioning in the older population

OBJECTIVE: Clinical research provides convincing evidence that total knee arthroplasty (TKA) is safe and improves joint-specific outcomes. However, higher-level functioning associated with self care and independent living has not been studied. Furthermore, most previous studies of the effects of TKA relied on relatively small clinical samples. We undertook this study to estimate the effects of TKA on 3 levels of physical functioning in a national sample of older adults. METHODS: Data were obtained from the Medicare Current Beneficiary Survey from 1992 to 2003. Medicare claims data identified participants with osteoarthritis of the knee who received TKA (n=259) or no TKA (n=1,816). Propensity scores were used to match treatment and no-treatment groups according to demographic characteristics, comorbid conditions, and baseline functioning. Three levels of physical functioning were examined as outcomes of TKA. These levels were represented by items on the Nagi Disability Scale, the Instrumental Activities of Daily Living (IADL) Scale, and the Activities of Daily Living (ADL) Scale. These items were measured after TKA and at comparable intervals for the no-treatment group. Average treatment effects were calculated for relevant Nagi Disability Scale, IADL Scale, and ADL Scale tasks. RESULTS: Between baseline and outcome assessments, TKA recipients improved on all 3 levels of physical functioning; the no-treatment group declined. Statistically significant average treatment effects for TKA were observed for one or more tasks for each measure of physical functioning. CONCLUSION: TKA is associated with sizeable improvements in 3 levels of physical functioning among elderly Medicare beneficiaries.     

Natural course of hemoglobin level after total knee arthroplasty and the benefit of tranexamic acid injection in the joint

We retrospectively investigated the natural course of hemoglobin (Hb) level after total knee arthroplasty (TKA) and identified the benefit of tranexamic acid injection at the operation field for unilateral TKA patients who have not received blood transfusions.There were 115 cases conducted by a surgeon who performed TKA without injecting tranexamic acid and 62 cases by another surgeon with injection. During 2-weeks of hospitalization, Hb level was checked on the day of surgery and 1, 2, 3, 5, 7, 11 days after surgery.Regardless of whether whom the operator was and tranexamic acid was injected or not, the same natural course of Hb level after TKA was observed. The lowest value of Hb was shown at postoperative day 3, after which it tended to recover. In repeated measures analysis of variance test, mean difference from preoperative Hb level showed a statistically significant difference between tranexamic acid injected and noninjected groups (P = .01). In post hoc test, the differences from preoperative Hb levels were significantly lower at all measurements in surgeon with injection of tranexamic acid.When deciding whether to transfuse after TKA, it should be noted that the patient tends to show the lowest Hb level on postoperative day 3. Also, the authors emphasize that tranexamic acid injection in the joint at the operation field is an effective method to reduce the loss of Hb after TKA.     

垫片设计对TKA术后髌骨倾斜和胫骨旋转运动的影响

目的探讨膝关节假体垫片设计对于全膝关节置换术（TKA）后膝关节运动学的影响。方法选取使用GENESISⅡ型假体行TKA的28位膝关节骨关节炎的患者,共42膝,平均随访27．7个月。按照使用垫片的种类分为高屈曲垫片组（23膝）和标准垫片组（19膝）,采用循环透视的方法对两组病例屈伸活动进行观察并储存DICOM数据。通过Image J医学影像处理软件对数据进行分析,使用CorelDRAW作图软件进行测量。通过对比两组病例在膝关节屈伸活动时胫骨内旋和髌骨倾斜等参数来分析垫片设计关节置换术后膝关节运动的影响。结果标准垫片组和高屈曲垫片组在术后活动度无差异（P=0．789）。两组在0°～120°范围活动时髌骨倾斜角无差异,活动范围达到130°时,两组有统计学差异（P=0．034）。两组在胫骨旋转活动上无差异。结论本研究结果表明垫片设计对TKA术后髌骨倾斜角有一定影响,对股胫旋转运动没有影响。     

Retrospective study of relationship between vastus medialis volume on SPECT-CT and outcome of unilateral total knee arthroplasty

Although the importance of quadriceps femoris function was reported previously, little is known about volume-related factors and their effects on clinical outcomes after total knee arthroplasty (TKA). We sought to determine whether there was a bilateral difference in vastus medialis muscle volume measured on single-photon emission computed tomography–computed tomography (SPECT-CT) in patients who underwent unilateral TKA. We also aimed to determine whether vastus medialis volume was related to osteoarthritis (OA) severity or scintigraphic uptake degree around the knee joint on SPECT-CT. And finally, we attempted to investigate the factors, such as vastus medialis volume and scintigraphic uptake degree, associated with the functional outcomes of TKA.This retrospective study included 50 patients (41 female, 9 male) undergone unilateral TKA due to primary OA. The maximal cross-sectional area of the vastus medialis was measured on axial SPECT-CT images. Scintigraphic uptake degrees and Kellgren-Lawrence (K-L) grade at the tibiofemoral joints were assessed. We compared maximal cross-sectional area of the vastus medialis on SPECT-CT for difference of bilateral lower limbs. We also analyzed the relationship between volume of vastus medialis and scintigraphic uptake measured on SPECT-CT and the severity of OA on conventional radiographs. The clinical outcomes were evaluated using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index at baseline and at 1 and 2 years after surgery. The relationship between preoperative muscle volume and scintigraphic uptake on SPECT-CT and WOMAC index was analyzed.The amount of muscle volume measured on SPECT-CT was smaller in operated limb in patients who underwent unilateral TKA. Preoperative vastus medialis muscle volume was not related to preoperative OA severity measured on conventional radiographs and scintigraphic uptake on SPECT-CT. However, a decreased vastus medialis muscle volume was related to worse clinical outcomes after TKA (P = .045), whereas the degree of scintigraphic uptake on SPECT-CT was not associated with postoperative clinical outcomes.Muscle volume of vastus medialis was decreased in the operated knee than in the nonoperated knee, and that was correlated with worse postoperative results. Even if the preoperative volume of vastus medialis were not related to OA severity on conventional radiographs and scintigraphic uptake on SPECT-CT, preservation and improvement of the muscle mass of the knee undergoing TKA is important.     

Total knee arthroplasty for severe haemophilic arthropathy: long-term experience in Taiwan

Summary. A number of articles have investigated the outcomes of total knee arthroplasty (TKA) and causes of prosthetic failure in patients with haemophilic arthropathy. The aims of this retrospective study were to evaluate the clinical and functional outcomes of TKA and causes of prosthetic failure in patients with haemophilic arthropathy. A consecutive series of 35 TKA in 26 patients with haemophilic arthropathy were performed between November 1985 and October 2006 by one experienced surgeon. The mean age at index operation was 34.2 years old (range: 23.4–47 years) and the mean follow‐up duration was 82.2 months (range: 12–218 months). Clinical assessment included range of flexion, range of extension and total range of motion (ROM). Functional evaluation comprised pain score and functional score by Dr. Insall’s Knee Society Clinical Rating System. The average preoperative ROM was 63.2° with flexion contracture 15°, whereas the average postoperative ROM was 79.8° with flexion contracture 5.5°. Improvement of range of flexion was 7.1° (P = 0.16); improvement of range of extension was 9.5° (P < 0.01). Average increase of total ROM was 16.6° (P = 0.02). Pain score by Knee Society was 7.1 points preoperatively and 48 points postoperatively (P < 0.01); functional score by Knee Society was 42 points preoperatively and 77.1 points postoperatively (P < 0.01). Three patients received manipulations because of an inadequate ROM. Three infection episodes were treated with debridement and one of them received arthrodesis after removal of prosthesis. Two patients received revision TKA. One of them was because of loosening of femoral component. The other one received revision TKA because of insert wear. Though improvement in range of flexion is insignificant in haemophilic arthropathy of knee after TKA, it showed significant increase in total ROM after operation, especially in improvement of flexion contracture. It also showed great pain relief and significant functional gain. Under the circumstance of acceptable infection rate and complication, TKA is an effective method to achieve pain relief and gain better function in patients with haemophilic arthropathy of knee. The data of this study confirm those previously published by many authors.