258例人工全膝关节置换术临床疗效分析

目的通过对10年258例人工全膝关节置换术的回顾性分析,探讨全膝关节置换术的近、中期临床疗效。方法 2000年1月至2010年1月,对258例266膝行全膝关节置换术,其中单侧膝关节置换250例,双侧膝关节同期置换8例16膝;行髌骨置换16例16膝。原发疾病包括骨性关节炎（234例）,类风湿性关节炎（15例）,创伤性关节炎（9例）。关节畸形包括膝内外翻畸形、屈曲挛缩畸形。216例（224膝）成功随访,随访时间4月～10年。手术前、后采用HSS膝关节评分系统。结果随访患者术后在疼痛、膝关节功能方面都有明显改善,尤其在疼痛缓解方面效果显著。膝关节活动度平均屈曲110°,膝关节HSS评分由术前的平均44.38分,增加到术后的平均91.43分,优良率达95.6%。结论人工全膝关节置换术近、中期疗效佳,术后膝关节功能和生活质量均有显著提高;掌握正确的手术适应证、完善的术前准备与术后有效的康复措施是获得良好疗效的保证。

Analysis of clinical results of 258 patients with total knee arthroplasty

Objective A retrospective analysis was conducted on 258 cases of knee arthroplasty in 10 years in order to study the clinical features of the patients and to observe the outcome of treatment.Methods From January 2000 to January 2010,266 cases of knee arthroplasty were performed in 258 patients.There were 250 unilateral TKA in 250 patients,and 16 bilateral TKAs in 8 patients.16 knees underwent patellar replacement in 16 patients.The diagnosis of the clinical conditions were osteoarthritis,rheumatism arthritis,and traumatic arthritis.Patients in this series also had several kinds of severe deformities,such as genu,varus,genu valgus,and flexion contracture of the knee.216 patients were followed-up after operation,and the date were analyzed by the HSS score system.Results The follow-up showed that the excellent and good results were achieved in 95.6% of the patitents.The pain was alleviated and function of knee was improved effectively after operation.Conclusion The therapeutics effect of total knee arthroplasty（TKA） was satisfactory,and a significant improvement was observed not only in the quality of life but also in function of knee.The short-term effect of TKA was satisfactory.The long-term outcome of TKA need further observation to be confirmed.Physical therapy is very important in the rehabilitation following operation.