全膝关节置换治疗僵硬膝关节疗效观察(1)
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[摘要] 目的：探讨全膝关节置换(TKA)治疗膝关节僵硬的疗效。方法：对经临床和X线证实的61例66膝膝关节僵硬行全膝关节置换，术后进行有效康复锻炼，观察术前及最后随访时膝关节屈伸活动范围，采用美国特种外科医院评分(HSS)等进行比较，评价其临床疗效并观察术后并发症发生情况。结果：本组61例患者最后随访时膝关节屈伸活动范围较术前显著改善[(95.0±11.3)° vs (40.4±4.9)°，t=2.782，P<0.01]，HSS评分较术前显著提高[(89.2±5.8)分vs(43.7±6.5)分，t=2.805，P<0.01]。经术后有效康复锻炼，本组疗效优良率为96.72%，共5例(8.19%)发生并发症。结论：结合术后合理康复锻炼，全膝关节置换治疗膝关节僵硬可获得较好的临床疗效，值得临床推广应用。
[关键词] 全膝关节置换；膝关节僵硬；疗效
[中图分类号] R687.4 [文献标识码] A [文章编号] 1673-7210(2011)07(a)-041-02
Observation on efficacy of total knee arthroplasty in the treatment of anchylosis of knee joint
ZHANG Yijun, ZHENG Liangxiao, WAN Lianping
Orthopaedic Hospital of Qingdao City, Shandong Province, Qingdao 266021, China
[Abstract] Objective: To investigate the efficacy of total knee arthroplasty (TKA) in the treatment of anchylosis of knee joint. Methods: A total of 61 cases (66 knees) with anchylosis of knee joint confirmed by clinical data and X-ray were performed TKA, and effective rehabilitation exercise was performed after surgery, the preoperative and follow-up flexion range of knee joint and HSS score were observed and compared, then the clinical efficacy and postoperative complications were also evaluated. Results: The follow-up flexion range of knee joint was significantly improved than preoperative [(95.0±11.3)° vs (40.4±4.9)°，t=2.782，P<0.01], HSS score was also improve than preoperative [(89.2±5.8) score vs (43.7±6.5) score， t=2.805，P<0.01]. After effective rehabilitation exercise, the fine and good rate was 96.72%, and 5 cases (8.19%) occurred complications. Conclusion: Combined with reasonable rehabilitation exercise, TKA can achieve a good efficacy in the treatment of anchylosis of knee joint, and thus it is worth applying in clinic.
[Key words] Total knee arthroplasty; Anchylosis of knee joint; Efficacy
全膝关节置换(total knee arthroplasty，TKA)是使用人工生物材料制成的关节假体置换病变的膝关节，以获得正常的膝关节功能[1]。全膝关节置换首次报道于20世纪60年代，研究报道，全膝关节置换假体10～15年生存率为85%～90%，是目前最为成功的外科治疗方法之一[2]，对于重症膝关节功能障碍患者是一种疗效确切的治疗方法，已成为常用手术。膝关节(knee joint)是人体最大、结构最复杂的关节，损伤机会较多，膝关节周围软组织创伤是导致膝关节僵硬(anchylosis of knee joint)的主要原因[3]。目前，随着人们生活水平的不断提高，对生活质量的要求也不断提高，对于有膝关节僵硬而要求行全膝关节置换术的患者也越来越多 ......
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