僵硬膝关节行人工全膝关节置换的效果及关节活动范围影响分析

目的 :观察人工全膝关节置换术治疗僵硬膝关节的临床效果及其影响因素。方法 :选取2010年1月至2014年10月采用人工全膝关节置换术治疗的20例(25膝)僵硬膝关节患者,其中男2例(3膝),女18例(22膝);年龄55~78岁,平均(64.5±4.9)岁;病程5~21年,平均8.3年。观察并比较手术前后HSS评分、并发症发生情况及关节活动范围(ROM)。结果:20例患者获得随访,时间12~69个月,平均35.3个月。术后10例患者出现并发症。HSS评分由术前的32.36±12.31提高至术后的80.70±18.52,两者比较差异有统计学意义。本组优7膝,良15膝,可3膝。膝关节ROM由术前的(39.4±5.3)°提高至末次随访时的(92.5±11.2)°。结论:僵硬膝关节行人工膝关节置换术是可行的,术后可获得满意的膝关节活动范围及功能。

Clinical efficiency and activity range of stiff knee by total knee arthroplasty

Objective: To observe clinical effect and influencing factor of total knee arthroplasty (TKA) for the treatment of stiff knee.Methods: From January 2010 to October 2014,20 patients(25 knees) with stiff knee were treated with TKA. Among them,including 2 males(3 knees) and 18 females(22 knees),aged from 55 to 78 years old with an average of(64.5±4.9) years old,the courses of disease ranged from 5 to 21 years with an average 8.3 years. Preoperative and postoperative HSS (hospital for special surgery knee score) score,activity range and complications were observed and compared.Results: All patients were followed up from 12 to 69 months with an average of 35.3 months. Ten patients occurred complications after operation. HSS score was improved from 32.36±12.31 preoperatively to 80.70±18.52 postoperatively,and had statistical difference between two groups;7 knees obtained excellent results,15 knees good and 3 knees moderate. Activity range was improved from(39.4±5.3)°preoperatively to (92.5±11.2)° at the latest follow up.Conclusion: Total knee arthroplasty for stiffness knees is feasible and could obtain satisfied activity range and function.