CAJ | 학술논문

目的：评估膝关节表面置换术的近期疗效，分析主要并发症发生的原因和预防方法。方法回顾分析自2010年1月~2013年12月在我院初次接受膝关节表面置换术的63例70膝患者资料，比较并分析术前和随访时患膝KSS和HSS评分、关节活动度检查等数据。结果通过各个时间段随访及X线检查结果的观察，正位片示膝关节人工假体位置安放好，关节间隙平衡；侧位片示人工关节假体大小合适，胫骨假体后倾角度良好，股骨假体包裹效果好。术后腓总神经麻痹2例，于术后4~6个月逐渐恢复。5例患者术后关节活动度较差，为(0~60±10)°，术后2~3周在强镇痛药物辅助下行手法松解处理；髌前痛1例，术后4个月经关节镜下行髌骨外侧支持带松解术后症状解除。随访时膝关节表面置换术后HSS及KSS评分均较术前显著提高。膝关节活动度从术前的(78.3±18.6)°提高至术后的(109.2±19.9)°(P<0. O1)。结论初次人工膝关节表面置换术对于消除膝关节疼痛，改善关节的活动功能效果明显，术后近期的并发症发生率低。
목적：평고슬관절표면치환술적근기료효，분석주요병발증발생적원인화예방방법。방법회고분석자2010년1월~2013년12월재아원초차접수슬관절표면치환술적63례70슬환자자료，비교병분석술전화수방시환슬KSS화HSS평분、관절활동도검사등수거。결과통과각개시간단수방급X선검사결과적관찰，정위편시슬관절인공가체위치안방호，관절간극평형；측위편시인공관절가체대소합괄，경골가체후경각도량호，고골가체포과효과호。술후비총신경마비2례，우술후4~6개월축점회복。5례환자술후관절활동도교차，위(0~60±10)°，술후2~3주재강진통약물보조하행수법송해처리；빈전통1례，술후4개월경관절경하행빈골외측지지대송해술후증상해제。수방시슬관절표면치환술후HSS급KSS평분균교술전현저제고。슬관절활동도종술전적(78.3±18.6)°제고지술후적(109.2±19.9)°(P<0. O1)。결론초차인공슬관절표면치환술대우소제슬관절동통，개선관절적활동공능효과명현，술후근기적병발증발생솔저。
Objective To evaluate the short-term effects of total knee arthroplasty ( TKA) , and to detect the causes and prevention of major complications. Methods It was a retrospective study since January 2010 to December 2013. There were 63 patients with 70 knees re-ceived primary TKA. KSS knee scores, HSS knee scores, and range of motion ( ROM) before the operation and during the follow-up were as-sessed and analysed. Results According to the results of follow-up and the X-ray observation, the anteroposterior radiographs showed that the artificial prosthesis were placed well and the joint gap were balanced;the lateral radiographs showed that the artificial joint prosthesis we-rer of appropriate size, good tilt angle, and good package effect. There were two cases developed peroneal nerve palsy and they gradually re-stored in 4 to 6 months after surgery. 5 cases were of poor postoperative ROM (0~60 ± 10)°. Strong analgesic medication-assisted release were conducted in 2 to 3 weeks after surgery. 1 case had patellar pain and resorted by arthroscopic lateral ligament of patellar releasing sur-gery. During the follow-up period, TKA significantly improved HSS and KSS scores compared to preoperative scores. ROM was increased from (78. 3 ± 18. 6)° preoperatively to (109. 2 ± 19. 9)° postoperative (P<0. 01). Conclusion TKA was effective to release knee pain, improve ROM and reduce the incidence of postoperative complications.