骨性关节炎与类风湿关节炎患者单侧膝关节置换术后围术期效果比较

目的 对比骨性关节炎（osteoarthritis,OA）与类风湿关节炎（rheumatoid arthritis,RA）患者单膝关节置换的围术期治疗效果。方法 2012年9月-2013年8月于本院骨科行单侧人工膝关节置换的骨性关节炎患者65例,类风湿关节炎患者43例,采用视觉模拟评分法（visual analogue scale,VAS）,关节活动度（range of motion,ROM）对两组患者进行术前、术后3 d、术后5 d评价,并比较两组患者住院时间、围术期并发症的差异。应用美国纽约特殊外科医院（Hospital for Special Surgery,HSS）膝关节评分对患者进行术前、术后1个月、3个月的功能评定。结果 术前两组各项评分差异无统计学意义（P〉0.05）,术后3 d、5 d OA组的ROM高于RA组（P〈0.05）,VAS评分低于RA组（P〈0.05）。RA组引流量、患肢膝上10 cm周径、住院时间、伤口并发症多于OA组（P〈0.05）。RA组术后1个月、术后3个月HSS评分低于OA组（P〈0.05）。结论 与骨性关节炎患者相比,类风湿关节炎患者人工膝关节置换术后围术期效果差。

Effects of the unilateral total knee arthroplasty in perioperative period between osteoarthritis and rheumatoid arthritis patients: A comparative study

Objective To compare the perioperative outcomes of total knee arthroplasty （TKA） between osteoarthritis （OA） and rheumatoid arthritis （RA） patients. Methods Clinical data about osteoarthritis patients （n=65） and rheumatoid arthritis patients （n=43） who underwent unilateral TKA in our department of orthopedics from September 2012 to August 2013 were recorded. The knee functional outcomes were compared between the two groups in preoperative period and 3 or 5 days after operation, including VAS score, range of motion （ROM）, length of hospitalization and complication rates. The knee functional outcomes were compared between the two groups in preoperative period or 1,3 months after operation according to Hospital for Special Surgery （HSS） score. Results The differences of preoperative condition between two groups were not significant （P 〉 0.05）. The 3,5 day postoperative ROM of OA group were higher than that of the RA group （P 〈 0.05）. While, the 3, 5 day postoperative VAS scores of OA group were lower than that of the RA group （P 〈 0.05）. Drainage volume, increasing rate of circumference length above 10 cm of the knee, length of hospitalization and wound related complication occurred more often in RA group than in OA group （P 〈 0.05）. The 1 and 3 months postoperative HSS score of RA groups were lower than that of OA group （P 〉 0.05）. Conclusion The TKA effects of RA patients in perioperative period are worse than that of OA patients.