全膝关节置换术治疗晚期类风湿性关节炎的早期临床疗效研究Early clinical effect of total knee arthroplasty in the treatment of advanced rheumatoid arthritis.pdfVIP

提 要 目的：研究全膝关节置换术(Total Knee arthroplasty ,TKA)治疗晚期类风湿性 关节炎的早期临床疗效。 方法：对我院 2010 年 3 月-2012 年 2 月共 24 例（30 膝）严重的类风湿性关节 炎患者行全膝关节置换术。对其临床资料进行总结、分析，经过定期随访，根据膝关 节活动度的测量、膝关节HSS评分以评价手术效果。本组病例全部选用后稳定型假体， 术中均未采用髌骨置换。手术后随访时对患者的膝关节进行评分，随访 3-27 月，平 均随访约12月。 结果：获得随访的患者膝关节活动度从术前平均（80.56±19.25）°改善到术后 平均（104.70±16.64）°。术前 HSS 评分平均为（47.6±13.1）分，术后 HSS 评分 平均为（84.2±14.2）分；根据 HSS 评分系统评定疗效：优 24 例，良 6 例。术后出 现刀口延迟愈合者2例，其余患者未出现其他并发症。随访X线片示假体位置、下肢 力线良好，未见有假体周围透亮区出现。 结论：对于符合TKA手术标准的晚期类风湿性关节炎患者可行膝关节置换手术治 疗，可以取得比较满意的早期临床疗效，长期疗效还需进一步观察。 关键词 类风湿性关节炎 膝关节 全膝关节置换术 临床疗效 The preliminary clinical outcome of total knee arthroplasty in the treatment of advanced rheumatoid arthritis Speciality：Orthopaedics of TCM Author ：Liu Qiang Tutor ：Qiu Hongming Abstract Objective: To investigate the preliminary clinical outcome of total knee arthroplasty in the treatment of advanced rheumatoid arthritis. Method: In hospital from March 2010 to February 2012, a total of 24 patients (30 knees) with rheumatoid arthritis underwent total knee arthroplasty. All patients were treated with posterior stabilized total knee system and without patellar replacement. All of them had been followed up for average 12 months(3-27 months).Clinical results were evaluated preoperatively and postoperatively using HSS scoring system, and the ranges of motion were measured ． Result: The ranges of motion of their knees were average 80.56±19.25 degrees preoperatively,and average 104.70±16.64 degrees postoperatively. The mean value of the scores according to HSS was average 47.6±13.1 preoperatively, and average 84.2±14.2 postoperatively. According to HSS, the results were excellent in 24 cases, good in 6