CAJ | 학술논문

目的：探讨影响高屈曲度假体活动度的影响因素。方法2013年8月-2014年8月于解放军总医院接受高屈曲度人工膝关节假体置换的182例患者纳入研究，通过填写问卷的方式采集数据资料：性别、年龄、体质量指数(body mass index，BMI)、术前诊断、髌骨是否置换、术前关节活动度、止血带应用时间、术前屈曲畸形程度、术前美国纽约特殊外科医院(Hospital for Special Surgery，HSS)膝关节评分和术后12个月的膝关节活动度。进行多因素分析。结果入组患者平均年龄63.2岁，男性62例，女性120例。相比膝关节活动度＜125°的患者，膝关节活动度≥125°的患者BMI低，术前膝关节活动度范围大，止血带时间短，术前屈曲畸形程度轻及术前HSS评分高(P＜0.05)。多因素分析结果显示，类风湿关节病、未行髌骨置换及术前关节活动度＜120°为术后高屈曲活动度的不利因素(P＜0.05)。结论与高屈曲度膝关节假体术后活动度有关的因素有BMI、术前HSS评分、病因、是否行髌骨置换、术前屈曲畸形程度和术前膝关节活动度。
목적：탐토영향고굴곡도가체활동도적영향인소。방법2013년8월-2014년8월우해방군총의원접수고굴곡도인공슬관절가체치환적182례환자납입연구，통과전사문권적방식채집수거자료：성별、년령、체질량지수(body mass index，BMI)、술전진단、빈골시부치환、술전관절활동도、지혈대응용시간、술전굴곡기형정도、술전미국뉴약특수외과의원(Hospital for Special Surgery，HSS)슬관절평분화술후12개월적슬관절활동도。진행다인소분석。결과입조환자평균년령63.2세，남성62례，녀성120례。상비슬관절활동도＜125°적환자，슬관절활동도≥125°적환자BMI저，술전슬관절활동도범위대，지혈대시간단，술전굴곡기형정도경급술전HSS평분고(P＜0.05)。다인소분석결과현시，류풍습관절병、미행빈골치환급술전관절활동도＜120°위술후고굴곡활동도적불리인소(P＜0.05)。결론여고굴곡도슬관절가체술후활동도유관적인소유BMI、술전HSS평분、병인、시부행빈골치환、술전굴곡기형정도화술전슬관절활동도。
Objective To explore factors affecting range of motion in patients accepting total knee replacement with highflexion prosthesis.Methods From August 2013 to August 2014, 182 patients accepting total knee replacement with highflexion prosthesis who accorded with our selection criteria were included. The following data were selected by the means of questionnaire: gender, age, body mass index (BMI), diagnosis, patella resurfacing, preoperative ROM, application time of tourniquet,flexion deformity, HSS score and ROM of 12 months after surgery. The data were recorded and analyzed.Results There were 62 males and 120 females in this study with mean age of 63.2 years. The results showed that knee ROM of patients in osteoarthritis (OA) and patella resurfacing group was better than that of patients in rheumatoid arthritis (RA) and patella non-resurfacing group. Secondly, in comparison with patients whose postoperative ROM was less than 125°, lower BMI, greater ROM before surgery, less tourniquet time, less level of deformity and better HSS score were found in patients whose postoperative ROM was greater than 125° (P<0.05). Finally, multivariate analysis showed that RA, non-resurfacing and preoperative ROM<100° were risk factors for postoperative ROM less than 120° (P<0.05).Conclusion The factors related to thefinal ROM for patients who accepted highflexion prosthesis include BMI, preoperative HSS scores, patella resurfacing, preoperative ROM and deformity.