高屈曲度全膝关节假体置换术治疗老年人膝骨关节病的疗效观察

目的：探讨高屈曲度全膝关节假体置换术治疗老年人膝骨关节病的临床疗效。方法68例患者（68膝）按照就诊顺序随机分为两组，分别采用高屈曲度全膝关节假体置换治疗和普通后稳定假体置换治疗，比较两组术前、术后3个月和术后1年采用美国特种外科医院（ HSS）评分标准和美国西部Ontario 和McMaster大学骨性关节炎指数（ WOMAC）评价膝关节功能、膝关节最大屈曲度和活动度及膝前痛发生率。结果治疗后3个月、1年HSS和WOMAC与治疗前差异均有统计学意义（观察组：t＝6．28、7．36，对照组：t＝5.23、7．35，均P＜0．05）；术后1年，观察组HSS与对照组差异有统计学意义（t＝4．69，P＜0．05）；术后3个月起观察组WOMAC与对照组差异有统计学意义（t＝6．49，P＜0．05）；治疗后3个月、1年，两组患者膝关节活动度与治疗前差异均有统计学意义（观察组：t＝5．24、4．66，对照组：t＝5．81、4．64，均P＜0．05）；术后1年，观察组最大屈曲度和关节活动度与对照组差异有统计学意义（t＝6．64、5．33，均P＜0．05）。观察组术后膝前痛发生率2．94％，对照组14．71％，两组发生率差异有统计学意义（χ2＝5．23，P＜0．05）。结论高屈曲全膝关节假体置换治疗老年人膝骨关节病可以改善术后远期膝关节功能和关节活动度，减少膝前痛发生。

Effects of high flexion total knee prosthesis treatment of senile knee osteoarthritis in elderly

Objective To investigate the elderly knee osteoarthritis high-flexion total knee prosthesis re-placement therapy clinical efficacy .Methods 68 patients（68 knees） were randomly divided into two groups in ac-cordance with the order of treatment ,each group was treated with high flexion total knee prosthesis replacement therapy＆amp;nbsp;and the general treatment of posterior stabilized prosthesis ,compared before and after surgery in March and after a in HSS,WOMAC knee function , maximum knee flexion and knee activity before the pain incidence .Results Two groups of patients HSS and WOMAC after treatment ,3 months,1 year compared with before treatment ,the differences were statistically significant（t=6.28,7.36,all P〈0.05）,the control group after treatment,3 months and 1 year compared with before treatment,there was statistically significant（t=5.23,7.35,all P〈0.05）;HSS in observation group after 1 year compared with the control group ,the difference was statistically significant （t=4.69,P〈0.05）, WOMAC after 3 months compared with the control group,the difference was statistically significant （t =6.49,P〈0.05）;Two groups of patients knee activity after treatment ,3 months,1 year compared with before treatment , the differences were statistically significant （t=5.24,4.66,all P〈0.05）,the control group after treatment ,3 months and 1 year compared with before treatment ,the differences were statistically significant （t=5.81,4.64,all P〈0.05）;ob-servation group after 1 year maximum flexion and range of motion and control group ,the difference were statistically significant（t=6.64,5.33,all P〈0.05）.The incidence of postoperative anterior knee pain of observation group and control were 2.94%,14.71%,there was statistically significant difference （χ2 =5.23,P〈0.05）.Conclusion Eld-erly high flexion knee osteoarthritis total knee prosthesis replacement therapy can improve long -term postoperative knee function and range of motion ,which also can reduce knee pain occur .