摘要
目的 探讨Ⅰ期双膝人工表面关节置换术的临床疗效。方法 选取我科Ⅰ期双膝人工表面关节置换术患者93例，采用纽约特种外科医院膝关节评分标准（HSS）评定临床疗效。72例获得随访，随访时间3—26个月（平均15．6个月）。结果 术后HSS评分平均89．6（55—96）分，优74例（79．6％），良15例（16．1％），可2例（3．2％），差2例（1．1％），手术优良率达95．7％。除肌力评分外，患者术后在疼痛、关节功能、活动度、屈曲畸形及稳定性等方面均有改善，与术前比较差异具有显著性（p〈0．05）。关节活动度由术前的平均88．9（25—110）°升至术后的平均99．8（75—135）°（P〈0．01）。术后出现深部静脉血栓形成2例（2．2％）、切121脂肪液化2例（2．2％）、深部感染1例（1．1％）、尿路感染1例（1．1％）、腓总神经损伤1例（1．1％）。未见假体松动、移位病例。无肺栓塞和死亡病例。结论 Ⅰ期双膝人工表面关节置换的患者能够获得良好的疗效，并发症的危险仍然存在，手术应在确保安全的前提下实施。
Objective To investigate the perioperative and early-term efficacy of bilateral total knee arthroplasty （BTKA） in one-stage procedure. Methods Totally 93 patients operated with BTKA in one-stage procedure from 2003 June to 2005 June were followed up and the curative effect was determined with Hospital for Special Surgery knee-rating system （HSS）. The complications were then analyzed. Results The mean postoperative HSS score was 89.6 （55 -96 scores） and the excellence/good rate reached 95.7% （excellent in 74 cases, good in 15 cases, moderate in 2 cases, and poor in 2 cases）. Except for the muscle power, the pain, joint function, range of joint movement （ ROM）, deformity, and stability were significantly improved after operation （P 〈0. 05 ）. The average ROM of knee was improved to 99.8 （75-135） degrees after operation from 88. 9 （25-110） degrees before operation （P 〈0. 01 ）. Complications included deep vein thrombosis （n = 2 ）, incision fat liquidation （ n = 2 ）, deep infection （ n = 1 ）, urinary infection （ n = 1 ）, and peroneal nerve palsy （n = 1 ）. No death was documented. Conclusion Bilateral total knee arthroplasty in one-stage procedure under secure conditions can be performed with good outcomes in selected patients without a definite increase in perioperative risk.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2006年第6期808-812,共5页
Acta Academiae Medicinae Sinicae
关键词
膝关节
关节成形术
双侧
疗效
knee joint
arthroplasty
bilateral
curative effect
