CAJ | 학술논문

目的：为了观察人工全膝关节置换术（ TKA）治疗膝关节类风湿性关节炎（ RA）的中短期治疗效果。方法随访2007至2011年间行TKA治疗的38例（58膝）膝关节RA患者。采用HSS评分、KSS评分、WOMAC评分、VAS视觉疼痛评分对术前及术后患者的膝关节功能进行评价、同时对术后随访影像学资料进行评价；采用SF-36量表对患者健康状况进行评价。结果所有患者均未出现感染且获得平均3.3年（2～6年）随访，膝关节功能均明显改善，患者膝关节HSS评分由术前45.92±13.49分提高到术后88.19±5.98分，两者采用配对t 检验比较差异有统计学意义（ P ＝0.00），其中优21膝，良34膝，优良率94.83％。膝关节屈曲畸形明显改善，膝关节活动度（ROM）由术前71.81°±32.58°提高到术后100.98°±13.99°，两者比较差异有统计学意义（ P＝0.00）。膝关节假体X线片采用膝关节学会的X线评价与计分系统评价未见假体松动。 SF-36评分中PCS由术前的26.27±3.91分提高到术后48.09±6.65分，两者比较差异有统计学意义（ P＝0.00）；MCS由术前的41.59±5.61分提高到51.83±5.44分，两者比较差异有统计学意义（ P＝0.00）。结论 TKA是治疗膝关节RA的有效方法，可提高患者生活质量。
목적：위료관찰인공전슬관절치환술（ TKA）치료슬관절류풍습성관절염（ RA）적중단기치료효과。방법수방2007지2011년간행TKA치료적38례（58슬）슬관절RA환자。채용HSS평분、KSS평분、WOMAC평분、VAS시각동통평분대술전급술후환자적슬관절공능진행평개、동시대술후수방영상학자료진행평개；채용SF-36량표대환자건강상황진행평개。결과소유환자균미출현감염차획득평균3.3년（2～6년）수방，슬관절공능균명현개선，환자슬관절HSS평분유술전45.92±13.49분제고도술후88.19±5.98분，량자채용배대t 검험비교차이유통계학의의（ P ＝0.00），기중우21슬，량34슬，우량솔94.83％。슬관절굴곡기형명현개선，슬관절활동도（ROM）유술전71.81°±32.58°제고도술후100.98°±13.99°，량자비교차이유통계학의의（ P＝0.00）。슬관절가체X선편채용슬관절학회적X선평개여계분계통평개미견가체송동。 SF-36평분중PCS유술전적26.27±3.91분제고도술후48.09±6.65분，량자비교차이유통계학의의（ P＝0.00）；MCS유술전적41.59±5.61분제고도51.83±5.44분，량자비교차이유통계학의의（ P＝0.00）。결론 TKA시치료슬관절RA적유효방법，가제고환자생활질량。
Objective To observe the Shorterm effects of the total knee arthroplasty ( TKA) in the patients with rheumatoid arthritis ( RA) .Methods A retrospective analysis was performed in 38 patients (58 knees) with RA, who had underwent TKA in 2007 to 2011.The clinical results were evaluated by HSS, KSS, WOMAC, and VAS visual scoring systems .The health status of the patients was evaluated by the Short Form 36-item Survey (SF-36).Results The average follow-up duration in this study was 3.3 years (range, 2~6 years).All the functions of the knee joint were improved after TKA .The average score of HSS was improved from the preoperative 45.92 ±13.49 to the 88.19 ±5.98 at the follow-up examination (P=0.00);21 cases were rated as excellent and 34 cases were rated as good (the excellent or good results rate was 94.83%) .The severe flexion deformities of the involving knees had been corrected completely.The average ranges of motion improved from the preoperative 71.81°±32.58°to the 100.98 ± 13.99 at the final follow-up.The extension range of the knee increased ( P =0.00 ).No loosening happened according to roentgen graphic evaluation and scoring system of the Knee Society .The mean value of the SF-36 scores showed an average improvement from 26.27 ±3.91 preoperatively to 48.09 ±6.65 at the final follow-up ( P =0.00 ) . The MCS showed an average improvement from 41.59 ±5.61 preoperatively to 51.83 ±5.44 at the final follow-up ( P =0.00 ) .Conclusion TKA is an effective method for treating the patients with RA , which can improve the patients'life quality.