全膝关节置换术治疗膝关节强直的临床研究

目的 探讨各种原因引起膝关节强直采用人工全膝关节置换治疗的手术技巧和临床效果.方法 2005年2月至2007年3月对4例(7膝)膝关节强直的患者施行人工膝关节置换术,其中1例化脓性关节炎骨性强直,2例类风湿性关节炎,1例强直性脊柱炎.术前记录关节活动度均为0°,KSS评分平均为42分(11～63分),功能评分平均17分(0～45分).结果 术后随访5～27个月,术后平均活动度83°(60°～110°),KSS评分平均为83分(64～91分)功能评分平均77分(60～90分),感染例数为0.结论 人工全膝关节置换手术治疗膝关节强直近期随访取得满意疗效,计算机导航辅助下进行股骨胫骨的截骨和软组织松解平衡,术后个体化功能康复训练是关键因素.

Clinical effects of total knee arthroplasty in the treatment of ankylosed knee

Objective To investigate the clinical effects of total knee arthroplasty in treatment ofankylosed knee caused by various reasons. Methods Four patients with 7 ankylosed knees, caused byankylosing spondylitis in 1 case, septic arthritis with bony ankylosis in 1 case, and rheumatoid arthritis in 2cases, underwent artificial knee replacement. Before the operation joint activity was 0°, Knee Society score(KSS) was 42 (11 - 63), and the function score was 17. Follow-up was conducted for 5 - 27months. Results Follow-up showed that the average joint activity was raised to 83° (60° - 110°) ,KSSscore to 83 (64 -91) points,and function score to 77 points. No infectious case was found. Conclusion Totalknee arthroplasty has a satisfactory effect in treatment of ankylosed knee. Computer assisted navigationsystem is helpful in femoro-tibial osteotomy and soft tissue balance. Individualized and directed rehabilitationis a pivotal factor.