黔南民族医专学报
黔南民族醫專學報
검남민족의전학보
JOURNAL OF QIANNAN MEDICAL COLLEGE FOR NATIONAL MINORITIES
2015年
1期
28-31
,共4页
全膝关节置换术%关节强直,伸直位%膝关节
全膝關節置換術%關節彊直,伸直位%膝關節
전슬관절치환술%관절강직,신직위%슬관절
total knee arthroplasty%ankylosis%extension position%knee
目的：探讨膝关节置换治疗膝关节伸直位强直的方法和疗效。方法：2008年3月至2014年2月，笔者采用膝关节置换治疗膝关节伸直位强直患者13例，男6例，女7例，平均年龄41.4岁（36.0～63.0岁），其中类风湿性关节炎3例，膝关节周围创伤10例；术前膝关节活动度（0±0）°，HSS评分（38±13.80）分，膝关节功能Lysholm评分（15±13.29）分。结果：全部病例行膝关节置换，平均随访48.7月（9.0～78.0月），末次随访时膝关节活动度（96±12.17）°，HSS 评分（85±7.15）分，膝关节功能Ly-sholm评分（82±6.94）分，手术前后对比统计学有非常显著差异。术后出现髌骨下极撕脱性骨折1例，髌韧带胫骨结节止点部分撕脱1例，切口皮缘部分坏死2例，切口浅表感染1例，经治疗后痊愈，3例分别存在5°、10°、15°伸膝滞缺。结论：膝关节置换治疗膝关节伸直位强直疗效满意，但手术难度大，术后并发症发生率高，且康复训炼至关重要。
目的：探討膝關節置換治療膝關節伸直位彊直的方法和療效。方法：2008年3月至2014年2月，筆者採用膝關節置換治療膝關節伸直位彊直患者13例，男6例，女7例，平均年齡41.4歲（36.0～63.0歲），其中類風濕性關節炎3例，膝關節週圍創傷10例；術前膝關節活動度（0±0）°，HSS評分（38±13.80）分，膝關節功能Lysholm評分（15±13.29）分。結果：全部病例行膝關節置換，平均隨訪48.7月（9.0～78.0月），末次隨訪時膝關節活動度（96±12.17）°，HSS 評分（85±7.15）分，膝關節功能Ly-sholm評分（82±6.94）分，手術前後對比統計學有非常顯著差異。術後齣現髕骨下極撕脫性骨摺1例，髕韌帶脛骨結節止點部分撕脫1例，切口皮緣部分壞死2例，切口淺錶感染1例，經治療後痊愈，3例分彆存在5°、10°、15°伸膝滯缺。結論：膝關節置換治療膝關節伸直位彊直療效滿意，但手術難度大，術後併髮癥髮生率高，且康複訓煉至關重要。
목적：탐토슬관절치환치료슬관절신직위강직적방법화료효。방법：2008년3월지2014년2월，필자채용슬관절치환치료슬관절신직위강직환자13례，남6례，녀7례，평균년령41.4세（36.0～63.0세），기중류풍습성관절염3례，슬관절주위창상10례；술전슬관절활동도（0±0）°，HSS평분（38±13.80）분，슬관절공능Lysholm평분（15±13.29）분。결과：전부병례행슬관절치환，평균수방48.7월（9.0～78.0월），말차수방시슬관절활동도（96±12.17）°，HSS 평분（85±7.15）분，슬관절공능Ly-sholm평분（82±6.94）분，수술전후대비통계학유비상현저차이。술후출현빈골하겁시탈성골절1례，빈인대경골결절지점부분시탈1례，절구피연부분배사2례，절구천표감염1례，경치료후전유，3례분별존재5°、10°、15°신슬체결。결론：슬관절치환치료슬관절신직위강직료효만의，단수술난도대，술후병발증발생솔고，차강복훈련지관중요。
Objective:To investigate the treatment method and curative effect of total knee arthroplasty for extension ankylosis of the knee. Methods:Total knee arthroplasty was performed to 13 patients with extension anky-losis of the knee from March 2008 to February 2014,including 6 male and 7 female patients with an average age of 41.4 years(36.0 -63.0 years),among whom 3 patients had rheumatoid arthritis and 10 patients had trauma around the knee joint. Before surgery,the range of motion was (0 ±0)°,the score of HSS and the Lysholm function score were(38 ±13.80)points and (15 ±13.29)points. Results:All of the 13 patients received total knee arthroplasty.The average follow-up was 48.7 months (9.0 -78.0 months). In the last follow-up,the range of motion was (96 ±12.17)°,the score of HSS and the Lysholm function score were (85 ±7.15)points and (82 ±6.94)points, indicating there were statistically significant differences before and after operation. The postoperative complications included patellar fracture in 1 patient,patellar tendon avulsion in 1 patient,part of incision necrosis in 2 patients and superficial infection in 1 patient. They were all cured after treatment,however,extension lag occurred in 3 pa-tients with degrees of 5°,10°and 15°respectively.Conclusion:Total knee arthroplasty for extension ankylosis of the knee can achieve satisfactory clinical results,but the operation is difficult and the chance of complications is high, and rehabilitation exercise is very important.
