滑膜切除对全膝关节置换术治疗骨性关节炎临床效果的影响

目的探讨滑膜切除对全膝关节置换术治疗骨性关节炎临床效果的影响。方法回顾性分析自2011-07—2014-12诊治的105例膝关节骨性关节炎,分为试验组和对照组,试验组(56例)行膝关节置换术与滑膜切除术,对照组(49例)只行膝关节置换术。记录并比较2组手术时间、术后引流量、隐性失血量、输血率及住院时间等,术前和术后随访时进行VAS评分、KSS评分及测量关节活动度。结果试验组获得随访(17.0±4.2)个月,对照组获得随访(15.0±3.1)个月。试验组手术时间、隐性失血量、术后引流量较对照组多,差异均有统计学意义(P0.05),2组住院时间及输血率差异无统计学意义(P0.05)。2组术后4周及1年随访时VAS评分、KSS临床评分、KSS功能评分差异无统计学意义(P0.05)。2组术后3 d及术后7 d关节活动度比较差异无统计学意义(P0.05)。结论与单纯行膝关节置换术相比,膝关节置换同时行滑膜切除术在治疗骨性关节炎上无优势,然而行滑膜切除术会导致更多的体内失血,延长手术时间,从而增加了手术风险。

Effect of synovectomy on clinical outcome of total knee arthroplasty for osteoarthritis

Objective To investigate the effect of synovectomy on clinical outcome of total knee arthroplasty (TKA) for osteoarthritis.Methods One hundred and five patients with osteoarthritis undergoing primary unilateral TKA between July 2011 and December 2014 were enrolled in this study,56 patients underwent TKA with synovectomy (study group) while 49 patients underwent TKA without synovectomy (control group).The operative time,hidden blood loss,length of hospital stay,drainage volume,blood transfusion rate were recorded.The KSS score,VAS pain score and range of motion were obtained.Results The length of follow-up was (17.0±4.2)months in study group and (15.0±3.1)months in control group.The operative time,hidden blood loss,drainage volume of study group was significandy higher than those of control group (P ＜0.05).There were no significant differences in length of hospital stay and blood transfusion rate between two groups (P ＞0.05).There were no significant differences in the KSS score,VAS pain score and range of motion between two groups at post-operation followup (P ＞0.05).Conclusion The synovectomy in TKA for patients with primary osteoarthritis does not have any clinical advantages.On the contrary,the patients suffer higher operation risk because of the more hidden blood loss,more drainage volume and longer operative time.