人工全膝关节置换术治疗严重膝骨关节炎(附41例报告)

对41例(64膝)膝骨关节炎(OA)患者施行人工全膝关节置换术(TKA)，术后平均随访11．6个月，并应用HSS膝关节评分系统进行分析。结果：患者术后在疼痛、功能及关节活动度等方面均有明显改善，缓解疼痛效果尤为显著。综和评定：优48膝(75％)，良12膝(18．75％)，可2膝(3．13％)．差2膝(3．12％)，优良率为93．75％。其中12例24膝同时行双TKA，采用自体血回输；41膝行髌骨置换，3膝(7．31％)术后出现髌前不适和疼痛；23膝未行髌骨置换，3膝(13．04％)出现髌前不适和疼痛。41例中，有4例(9．8％)术后下肢发生深静脉血栓形成，不保留后交叉韧带(PCL)的后方稳定型假体55膝中，综合评定可者2膝，差者1膝；保留PCL型假体9膝中，1膝综合评定差。认为TKA治疗严重膝骨关节病效果满意，术后有效的康复措施和功能锻炼甚为重要。

The treatment of severe osteoarthropathy with total knee arthroplasty：41 case reports

41 patients with osteoarthnitis (64knees)had been performed to tal knee arthoroplast (TKA),and analysized by HSS knee score system The average post operated follow up time was 11 6 months It resulted all patient that acquired excellent improvement in pain,function and range of motiom(ROM),especially in pain improvement Among the general evaluation there were 48 best knees(75%),12 better knees(18 75%),2 good knees(3 13%)and 2 poor knees(3 12%) The excellent rate was 93 75% Among them,12 cases (24 knees) performed bilateral TKA and treated with autotransfusion 41 knees performed patellar resurfaccing;3 cases (7 31%) occurred anterpatellar discomfort and pain;and 23 knees didn't performed patellar resurfaccing;3 cases (13 04%) occurred anterpatellar discomfort and pain and 4 cases occured deep venousthrombosis Among 55 knee posterior cruciate ligments(PCLs) removed arthroplasty there were 2 cases good and 1 poor case Among 9 knee PCLs retained arthroplasty,1 case was poor In conclusion,TKA is an excellent method in the treatment of severe osteoarhropathy Function tain and rehabilitate methods are very important after operation