人工膝关节置换术治疗膝关节重度骨性关节炎58例临床疗效

目的探讨人工膝关节置换术治疗膝关节重度骨性关节炎临床疗效。方法对58例重度膝骨性关节炎行人工膝关节置换术,观察患者术后HSS评分、膝关节屈曲挛缩度及关节活动度情况。结果对58例患者随访9~36(15±2)个月,2例膝切口局部脂肪液化,经换药愈合。其余患者均无切口及关节内感染或关节松动。疗效优49例,良5例,优良率为93.1%,膝关节HSS评分从术前(36.5±2.8)分增加到术后(90.6±6.3)分,关节活动度由术前(32.2±11.8)°增加到术后(98.5±13.6)°,膝关节屈曲挛缩度由术前(18.5±1.3)°降低到术后(0.4±0.1)°,差异有统计学意义(P<0.05)。结论人工膝关节置换术应用于严重骨性关节炎的治疗,能有效缓解疼痛,改善关节功能及生活质量。

Clinical effect of total knee arthroplasty on 58 patients with severe osteoarthritis of knee joints

Objective To study the clinical treatment effect of total knee arthroplasty （TKA） on severe osteoarthritis of knee joint. Methods A total of 58 patients with severe osteoarthritis of knee joints were treated by artificial joint replacement surgery. The parameters, such as postoperative HSS score, contracture degree and joint mobility, were observed. Results After 9 - 36 （ 15 ± 2） months＇ follow-up, 2 knees suffered from local fat liquefaction in incision and were cured by exchanging dressing. There was neither incision and intra-articular infection nor joint looseness. Regarding HSS system, there were 49 patients with best knees and 5 ones with better knees, with an excellent and good rate of 93.1%. The improvements in HSS score and joint mobility were from preoperative 36.5 ± 2.8 to postoperative 90.6 ± 6.3 points and from preoperative 32.2 ± 11.8 to postoperative 98.5 ± 13.6 degrees. The reduction of contraeture was from preoperative 18.5 ± 1.3 to postoperative 0.4 ± 0.1 degrees. The differences were statistically significant （ P 〈 0.05 ）. Conclusion TKA for patients with severe osteoarthritis may effectively alleviate the pain and lead to improvement in knee function and life quality.