CAJ | 학술논문

目的探讨全膝关节置换术治疗强直性脊柱炎严重膝关节病变的手术方法及临床疗效。方法回顾性分析2007年1月至2012年8月强直性脊柱炎严重膝关节病变行全膝关节置换联合髌骨成形术的全部病例，共10例（18膝）。其中男9例（17膝）、女1例（1膝），术前HSS评分平均为45分（32～65分），膝关节运动范围平均为17.5°（0～60°），术前HSS疼痛评分平均为8分（5～15分），屈曲挛缩畸形30.8°（5°～65°），比较分析手术前后膝关节HSS评分、运动范围、疼痛评分等差异。结果术后随访时间平均为17.5个月（2～60个月），术后HSS评分为（84.0±10.3）分（ t＝-8.507， P＜0.01）、HSS疼痛评分为24.5±3.2分（ t＝-11.645，P＜0.01）、膝关节运动范围为82.1°±14.4°（ t＝-7.477，P＜0.01）、屈曲挛缩畸形为11.3°±14.2°（t＝0.014，P＜0.05），膝关节HSS评分、运动范围、疼痛评分、屈曲挛缩畸形均较术前显著改善。结论全膝关节置换联合髌骨成形术是有效的治疗强直性脊柱炎严重膝关节病变的有效手段，可缓解关节疼痛、恢复关节功能、改善患者生存质量、提高患者满意度。
목적탐토전슬관절치환술치료강직성척주염엄중슬관절병변적수술방법급림상료효。방법회고성분석2007년1월지2012년8월강직성척주염엄중슬관절병변행전슬관절치환연합빈골성형술적전부병례，공10례（18슬）。기중남9례（17슬）、녀1례（1슬），술전HSS평분평균위45분（32～65분），슬관절운동범위평균위17.5°（0～60°），술전HSS동통평분평균위8분（5～15분），굴곡련축기형30.8°（5°～65°），비교분석수술전후슬관절HSS평분、운동범위、동통평분등차이。결과술후수방시간평균위17.5개월（2～60개월），술후HSS평분위（84.0±10.3）분（ t＝-8.507， P＜0.01）、HSS동통평분위24.5±3.2분（ t＝-11.645，P＜0.01）、슬관절운동범위위82.1°±14.4°（ t＝-7.477，P＜0.01）、굴곡련축기형위11.3°±14.2°（t＝0.014，P＜0.05），슬관절HSS평분、운동범위、동통평분、굴곡련축기형균교술전현저개선。결론전슬관절치환연합빈골성형술시유효적치료강직성척주염엄중슬관절병변적유효수단，가완해관절동통、회복관절공능、개선환자생존질량、제고환자만의도。
Objective To retrospectively evaluate the outcome of total knee arthroplasty for the ankylosing spondylitis ( AS) with severe knee arthropathy .Methods From January 2007 to August 2012 AS patients who received total knee replacement combined with the patelloplasty was 10 patients (18 knees).The mean preoperative HSS score was 45 ( 32-65 ) , the mean preoperative ROM was 17.5 degrees ( 0-60 degree ) , the mean contracture deformity was 30.8 degree ( 5-65 degree ) .Comparing and analyzing scores change between the pre-operation and post-operation.Results The follow-up was 17.5 months (2-60 months).The mean postoperative HSS score was 84 ±10.3(t=-8.507,P<0.01),the mean postoperative ROM was 82.1 ±14.4 degree(t=-7.477,P<0.01), the mean postoperative contracture deformity was 11.25 ±14.2 degree ( t=0.014 , P<0.05 ) .These datas change were significant between pre-operation and post-operation.Conclusions TKA combined Patelloplasty was effective treatment for AS with the severe arthropathy of knee joint ,improving the clinical outcome ,quality of patient life .