CAJ | 학술논문

目的：探讨人工全膝关节置换术（total knee arthroplasty， TKA）治疗严重畸形膝关节的手术方法和临床疗效。方法对人工全膝关节置换术916例（1031膝），严重畸形膝关节置换术80例，其中56例（70膝）成功随访。严重内翻畸形19例（23膝）、严重外翻畸形21例（27膝）、严重屈曲畸形16例（20膝）。术后平均随访时间60个月（6个月～10年）。对膝关节屈伸活动度、HSS、KSS膝关节评分系统对手术前后进行回顾性研究。结果膝关节屈伸活动度由术前平均80°（伸直0°～屈曲120°）提高到术后115°（伸直0°～屈曲130°），膝关节评分系统 HSS、KSS术前及随访时比较差异有统计学意义（P＜0．05），KSS评分：临床评分由术前平均33分（10～68分）提高到术后平均81分（70～100分），HSS临床评分由术前平均43分（27～68分）提高到术后平均86分（72～100分）。膝内外翻、屈曲挛缩畸形得到较好矫正。结论严重畸形膝关节通过关节置换术同样能恢复正常的关节功能，提高了患者生活质量，获得满意的临床疗效。
목적：탐토인공전슬관절치환술（total knee arthroplasty， TKA）치료엄중기형슬관절적수술방법화림상료효。방법대인공전슬관절치환술916례（1031슬），엄중기형슬관절치환술80례，기중56례（70슬）성공수방。엄중내번기형19례（23슬）、엄중외번기형21례（27슬）、엄중굴곡기형16례（20슬）。술후평균수방시간60개월（6개월～10년）。대슬관절굴신활동도、HSS、KSS슬관절평분계통대수술전후진행회고성연구。결과슬관절굴신활동도유술전평균80°（신직0°～굴곡120°）제고도술후115°（신직0°～굴곡130°），슬관절평분계통 HSS、KSS술전급수방시비교차이유통계학의의（P＜0．05），KSS평분：림상평분유술전평균33분（10～68분）제고도술후평균81분（70～100분），HSS림상평분유술전평균43분（27～68분）제고도술후평균86분（72～100분）。슬내외번、굴곡련축기형득도교호교정。결론엄중기형슬관절통과관절치환술동양능회복정상적관절공능，제고료환자생활질량，획득만의적림상료효。
Objective To investigate the methods and clinical results of total knee arthroplasty ( TKA) in patients with severe knee deformity.Methods From February 1999 to December 2012,916 patients (1031 knees) underwent TKA in this hospital ,inclu-ding 80 patients with severe knee deformity ,of which,56 patients (70 knees) were followed up,among them,19 patients (23 knees) with varus knee deformity,21 patients (27 knees),patients with severe flexion deformity were 16 patients (20 knees) knee flexion de-formity.The mean follow-up period was 60 months(ranging from 6 months to 10 years).To evaluate the outcomes of TKA at the time of pre-operation and follow-up respectively,range of motion(ROM),the HSS score and the KSS score were used.Results The average ROM improved from 80°(0°-120°) preoperatively to 115°(0°-130°) postoperatively.The HSS score and the KSS score were signifi-cantly improved compared with pre-operation(P<0.05).KSS improved from 33 points (10-68 points) preoperatively to 81 points (70-100 points),HSS improved from 43 points (27-68 points) preoperatively to 86 points (72-100 points).Varus knee deformity,val-gus knee defoimity and flexion deformity were corrected .Conclusions TKA improves the function of knee effectively and the quality of patients'life.The effect of TKA is satisfactory .