CAJ | 학술논문

目的:观察采用旋转平台膝关节假体行人工膝关节置换治疗膝关节疾病的疗效.方法:回顾性分析2005-01/2009-01山东大学附属省立医院收治的行人工膝关节置换患者62例(74膝),男36例(41膝),女26例(33膝);年龄52～79岁,平均61.5岁;左侧28例,右侧22例,双侧12例.其中骨性关节炎34例,类风湿性关节炎21例,创伤性关节炎7例.所有患者均选用旋转平台膝关节假体进行置换,且为首次置换,未置换髌骨.采用HSS膝关节评分标准对置换前后膝关节功能进行评估.结果:62例(74膝)患者均进行了随访,时间3~48个月,平均22个月.病例刀口均一期愈合,未出现感染和明显关节血肿.2例术后3d出现下肢肿胀,经超声多普勒检查确诊轻度下肢深静脉血栓形成,给予低分子肝素钠和拜阿司匹林等药物治疗,10d后肿胀消退.62例患者术后疼痛解除,功能明显改善.置换前HSS评分为34～58分,平均44.99分;置换后69～98分,平均88.78分,其中优45例(55膝),良16例(18膝),可1例,优良率98%.X射线平片未发现存在假体周围的X射线透亮区,亦未发现假体脱位征象.结论:选用旋转平台膝关节假体行人工膝关节置换治疗膝关节病手术简便,术后恢复好,并发症少,短期临床效果满意.
목적:관찰채용선전평태슬관절가체행인공슬관절치환치료슬관절질병적료효.방법:회고성분석2005-01/2009-01산동대학부속성립의원수치적행인공슬관절치환환자62례(74슬),남36례(41슬),녀26례(33슬);년령52～79세,평균61.5세;좌측28례,우측22례,쌍측12례.기중골성관절염34례,류풍습성관절염21례,창상성관절염7례.소유환자균선용선전평태슬관절가체진행치환,차위수차치환,미치환빈골.채용HSS슬관절평분표준대치환전후슬관절공능진행평고.결과:62례(74슬)환자균진행료수방,시간3~48개월,평균22개월.병례도구균일기유합,미출현감염화명현관절혈종.2례술후3d출현하지종창,경초성다보륵검사학진경도하지심정맥혈전형성,급여저분자간소납화배아사필림등약물치료,10d후종창소퇴.62례환자술후동통해제,공능명현개선.치환전HSS평분위34～58분,평균44.99분;치환후69～98분,평균88.78분,기중우45례(55슬),량16례(18슬),가1례,우량솔98%.X사선평편미발현존재가체주위적X사선투량구,역미발현가체탈위정상.결론:선용선전평태슬관절가체행인공슬관절치환치료슬관절병수술간편,술후회복호,병발증소,단기림상효과만의.
OBJECTIVE: To study the therapeutic effect of treating knee arthropathy with total knee arthroplasty using rotating-platform knee prosthesis. METHODS: A total of 62 patients (74 knees) in Provincial Hospital Affiliated To Shandong University from January 2005 to January 2009 were selected, including 36 males (41 knees) and 26 females (33 knees), aged 52-79 years, mean aged 61.5 years; 28 cases with left knee, 22 cases with right knee and 12 cases of both knees. The cases were composed of 34 cases with osteoarthritis, 21 cases with rheumatoid arthritis and 7 cases with traumatic arthritis. All the patients received the total knee arthroplasty for the first time using rotating-platform knee prosthesis, no replacement of the patella. The clinical results of pre-operetion and after-operation were evaluated by the HSS knee rating score system. RESULTS: All the patients were followed-up for averaged 22 months (3-48 months) after operation. Incisions of all the cases were healed, and there was no infection and hematoma. Lower extremity deep venous thrombosis occurred in 2 cases at 3 days after operation. Swelling disappeared through drug treatment 10 days later. Pain and function of all the patients were obviously ameliorated after operation. The average HSS knee rating score was 44.99 (from 34 to 58) before total knee arthroplasty, which was improved to 88.78 (from 69 to 98), and the good-to-excellent rate was 98% (excellent 45 cases, good 16 cases, average 1 case). There were no signs of prosthetic dislocation or loosening in the X-ray films. CONCLUSION: Total knee arthroplasty using rotating-platform knee prosthesis owns advantages of easy surgical operation, tess complications, good recovery and satisfactory results in a short-term.