双侧一期人工膝关节置换术临床疗效分析

目的 探讨双侧一期人工全膝关节置换术（TKA）治疗双侧膝关节疾患的临床疗效.方法 分析2011年11月～2012年11月年因双膝原发性骨关节炎接受双膝TKA且随访资料满1年的患者53例,分为一期手术组（26例）和分期手术组（27例）,比较两组患者治疗因素和疗效间的差异,并统计并发症的种类及例数.结果 一期手术组总住院时间明显少于分期手术组,但是一期组总手术时间、术中总出血量及总输血量明显高于分期组,两组差异均具有统计学意义（均P＜0.05）;两组患者术前HSS评分、术后1年时HSS评分及HSS评分改善程度比较,差异均无统计学意义（均P＞0.05）,两组仅有小腿肌间静脉发生血栓,且发病率差异无统计学意义（P＞0.05）.两组均无严重并发症及死亡病例发生.结论 双侧一期人工膝关节置换术是治疗双侧膝关节疾患的有效方法,临床疗效显著,并发症的发生率亦无明显增加.

Clinical effect analysis of bilateral simultaneity total knee arthroplasty

Objective To investigate the clinical effect of bilateral simultaneity TKA in the treatment of bilateral knee joint diseases.Methods 53 patients with primary osteoarthritis of both knee joints received bilateral and follow-up for at least 1 years.The patients were grouped into simultaneous group and staggered group.The curative effect and complications were analyzed.Results The total hospitalization time of the simultaneous group was less than that of the staggered group,but the total operation time,intraoperative blood loss and total blood transfusion volume were significantly higher than that of the staggered group （P〈0.05）.The HSS scores before operation and 2 years after operation were also not significantly different （P〉0.05）.The wound complication rate was higher in the simultaneous group than the staggered group.Thromboembolism events occurred only in calf muscular veins in both groups with similar incidences.No patients suffered from severe complication recorded during hospital stay.Conclusion The bilateral simultaneity TKA is a effective method in treating bilateral knee joint diseases.