人工全膝关节置换术治疗类风湿性关节炎的疗效分析

目的探讨人工全膝关节置换术治疗类风湿性关节炎的临床效果。方法对35例类风湿性关节炎患者(64膝)进行全膝关节置换。根据软组织平衡情况采用后稳定型膝关节非限制性假体(58膝)或者限制性假体(6膝)。根据HSS评分系统对患者手术前后的膝关节功能进行评分。结果 35例均获随访,时间6个月~7年。关节功能明显改善,尤其是在畸形矫正方面效果显著。HSS评分:优27例,良4例,可4例,优良率达88.5%。无感染发生及深静脉血栓形成。结论类风湿性关节炎病理改变复杂,手术难度大,需要很好的软组织平衡技术,韧带损伤严重者需要采用限制性假体才能取得满意的疗效。

Clinical analysis of total knee arthroplasty for rheumatoid arthritis

Objective To study the effect of total knee arthroplasty （ TKA） for rheumatoid arthritis. Methods 35 cases （64 knees） with late stage rheumatoid arthritis were undergone TKA. The prostheses were selected according to soft tissue balance. 58 knees were performed TKA with nonconstrained prostheses,while 6 with constrained prosthe-ses. The function of the knee joint was evaluated prior to and after surgery according to the HSS scoring system. Re-sults 35 cases were followed up for 6 months-7 years, the joint function was improved,and the deformities were corrected. Based on HSS scoring system of knee joint function, the results were excellent in 25 cases, good in 4, and fair in 4, and the excellent and good rate was 88. 5%, No infection and deep vain thrombosis were found. Conclu-sions Pathology change of knee rheumatoid arthritis is complex, so the good operative skills, especially soft tissue balance are demanded. Constrained prosthesis is required for those with ligament compromises.