CAJ | 학술논문

目的：观察人工全膝关节置换术（TKA）治疗类风湿性关节炎短期临床疗效。方法：对36例（47膝）类风湿关节炎（RA）患者施行TKA，采用HSS评分对患者术前术后膝关节功能进行评估，同时对术后的影像学资料进行评价，采用SF‐36健康量表对患者术前术后的生活质量进行评估，采用满意度量表对TKA后患者满意度进行对比。结果：31例（40膝）获得平均（3．65±0．95）年（2～5年）随访，膝关节HSS评分由术前平均（44．89±13．95）分提高到术后平均（88．46±5．97）分，手术前后比较差异有统计学意义，其中优秀26膝，良好11膝，可2膝，差1膝，优良率92．50％；膝关节活动度由术前（70．05±25．71）°提高到术后（97．26±15．29）°，术前、术后的ROM比较差异有显著意义；膝关节内外翻畸形、屈曲挛缩畸形状况也得到改善。膝关节假体采用膝关节学会X线评价与计分系统评价未见假体松动。患者术后SF‐36评分各评分均较术前得到明显改善，其中PCS术前平均（27．48±4．59）分，提高至术后平均（47．68±6．98）分，手术前后比较差异有统计学意义；MCS术前平均（42．46±5．63）分，提高至术后平均（53．99±5．74）分，手术前后比较差异有统计学意义。患者TKA后随访满意度满意率90％。结论：TKA治疗类风湿性关节炎短期临床疗效良好，患者生活质量得到明显提高，且满意度高。
목적：관찰인공전슬관절치환술（TKA）치료류풍습성관절염단기림상료효。방법：대36례（47슬）류풍습관절염（RA）환자시행TKA，채용HSS평분대환자술전술후슬관절공능진행평고，동시대술후적영상학자료진행평개，채용SF‐36건강량표대환자술전술후적생활질량진행평고，채용만의도량표대TKA후환자만의도진행대비。결과：31례（40슬）획득평균（3．65±0．95）년（2～5년）수방，슬관절HSS평분유술전평균（44．89±13．95）분제고도술후평균（88．46±5．97）분，수술전후비교차이유통계학의의，기중우수26슬，량호11슬，가2슬，차1슬，우량솔92．50％；슬관절활동도유술전（70．05±25．71）°제고도술후（97．26±15．29）°，술전、술후적ROM비교차이유현저의의；슬관절내외번기형、굴곡련축기형상황야득도개선。슬관절가체채용슬관절학회X선평개여계분계통평개미견가체송동。환자술후SF‐36평분각평분균교술전득도명현개선，기중PCS술전평균（27．48±4．59）분，제고지술후평균（47．68±6．98）분，수술전후비교차이유통계학의의；MCS술전평균（42．46±5．63）분，제고지술후평균（53．99±5．74）분，수술전후비교차이유통계학의의。환자TKA후수방만의도만의솔90％。결론：TKA치료류풍습성관절염단기림상료효량호，환자생활질량득도명현제고，차만의도고。
objective :To observe the short‐term clinical effect of total knee arthroplasty (TKA) in pa‐tients with Rheumatoid Arthritis (RA) .Methods :The clinical results of 36 patients (47 knees) were evaluated by using HSS scoring system .The patients’ health statuses were evaluated by using the Short Form 36‐item Survey (SF‐36) .The patients’ satisfaction scores were evaluated by using the British Orthopaedic Association patient‐satis‐faction score .The postoperative X‐ray imaging data were analyzed at the last follow‐up .Results :31 patients (40 knees) obtained an average follow‐up of 3 .65 years (from 2 to 5 years) .All functions of knee joint improved after TKA .The mean value of the scores according to HSS was average improved from the preoperative (44 .89 ± 13 .95) to the (88 .46 ± 5 .97) at the follow‐up examination ,with 26 cases rated as excellent and 11 as good (excellent or good results rate of 92 .50% ) .The serious flexion deformities of the involved knees had been corrected .The average ranges of motion improved from the preoperative (70 .05 ± 25 .71)°to the (97 .26 ± 15 .29)°at the follow‐up .No loos‐ening happened according to The Knee Society total knee arthroplasty roentgen graphic evaluation and scoring sys‐tem .The mean value of the scores based on the SF‐36 scores PCS showed an average improvement from (27 .48 ± 4 . 59) preoperatively to (47 .68 ± 6 .98) at follow‐up .The MCS showed an average improvement from (42 .46 ± 5 .63) preoperatively to (53 .99 ± 5 .74) at follow‐up .The very satisfactory or satisfactory results rate of 90% .Conclusion :The short‐term of clinical effect of TKA in patients with RA is satisfactory ,which also can be used to improve the patients’ quality of life .