CAJ | 학술논문

目的比较全膝关节初次单侧表面置换与双侧同时置换术后并发症的发生情况.方法对2006年11月至2009年11月收治且获得随访的339例初次行全膝关节表面置换患者的资料进行回顾性分析,根据是否行双膝关节表面置换分为两组:单膝置换组(行单侧膝关节表面置换)178例,男50例,女128例;平均年龄64.2岁(26～81岁);术前美国膝关节协会(KSS)评分平均为(34.0±13.3)分.双膝置换组(行双侧膝关节表面置换)161例,男32例,女129例;平均年龄65.3岁(34～80岁);术前KSS评分平均为(33.4±11.1)分.比较两组患者术后并发症的发生情况,并采用KSS评分评定临床疗效.结果 339例患者术后获3个月至3年(平均18.4个月)随访.单膝置换组术后并发症发生率为6.2%(11/178),双膝置换组术后并发症发生率为4.3%(7/161),两组比较差异无统计学意义(x2=0.564,P=0.453).末次随访时单膝置换组KSS评分平均为(92.5±10.6)分,双膝置换组平均为(91.9±11.1)分,两组比较差异无统计学意义(t=0.511,P=0.610).结论双膝关节置换与单膝关节置换术后并发症发生率无明显差异.术前充分准备、较好的手术技术、完善的术后监测和支持治疗及合理的康复训练,可以降低一期舣膝关节置换术后并发症的发生率;但对于术前合并多种内科疾病的患者,应认真评估手术耐受性后再进行抉择.
목적 비교전슬관절초차단측표면치환여쌍측동시치환술후병발증적발생정황.방법대2006년11월지2009년11월수치차획득수방적339례초차행전슬관절표면치환환자적자료진행회고성분석,근거시부행쌍슬관절표면치환분위량조:단슬치환조(행단측슬관절표면치환)178례,남50례,녀128례;평균년령64.2세(26～81세);술전미국슬관절협회(KSS)평분평균위(34.0±13.3)분.쌍슬치환조(행쌍측슬관절표면치환)161례,남32례,녀129례;평균년령65.3세(34～80세);술전KSS평분평균위(33.4±11.1)분.비교량조환자술후병발증적발생정황,병채용KSS평분평정림상료효.결과 339례환자술후획3개월지3년(평균18.4개월)수방.단슬치환조술후병발증발생솔위6.2%(11/178),쌍슬치환조술후병발증발생솔위4.3%(7/161),량조비교차이무통계학의의(x2=0.564,P=0.453).말차수방시단슬치환조KSS평분평균위(92.5±10.6)분,쌍슬치환조평균위(91.9±11.1)분,량조비교차이무통계학의의(t=0.511,P=0.610).결론쌍슬관절치환여단슬관절치환술후병발증발생솔무명현차이.술전충분준비、교호적수술기술、완선적술후감측화지지치료급합리적강복훈련,가이강저일기의슬관절치환술후병발증적발생솔;단대우술전합병다충내과질병적환자,응인진평고수술내수성후재진행결택.
Objective To compare postoperative complications in patients firstly undergoing primary unilateral total knee arthroplasty (UTAK) and simultaneous bilateral total knee arthroplasty (SBTKA) .Methods From November 2006 to November 2009, 339 patients underwent primary UTAK and SBTKA in our hospital and followed up. The UTKA group had 178 patients (50 men and 128 women) who were aged from 26 to 81 years (mean, 64. 2 years) and a mean American Knee Society Score (KSS) of 34. 0 ± 13. 3points before surgery. The SBTKA group had 161 patients (32 men and 129 women) who were aged from 34 to 80 years (mean, 65. 3 years) and a mean KSS of 33. 4 ± 11. 1 points before surgery. The postoperative complications were compared between the 2 groups and clinical outcomes were evaluated according to KSS system. Results The patients were followed for 18. 4 months on average (range, 3 months to 3 years) . The incidence of postoperative complications was 6. 2% (11/178) in the UTKA group and 4. 3% (7/161) in the SBTKA group, with no significant difference (x2 =0. 564, P = 0. 453) . The KSS score at the final follow-up was all increased in both groups. It was 92. 5 ± 10. 6 in the UTKA group and 91. 9 ± 11. 1 in the SBTKA group, with no significant difference (t =0.511, P = 0.610). Conclusions SBTKA is not an independent risk factor for postoperative complications. Careful operative preparation and assessment, good surgical skills, comprehensive postoperative monitoring and supporting management, and proper rehabilitation can significantly reduce complications following SBTKA. But for a patient who has been complicated with multiple internal diseases, SBTKA decision should not be made before a careful tolerance assessment of the patient.