CAJ | 학술논문

目的：探讨人工全膝关节置换术治疗单侧膝内翻合并屈曲挛缩畸形的临床效果，为临床治疗提供依据。方法选择2009年6月至2014年6月收治的35例单侧膝内翻合并屈曲挛缩畸形的患者为研究对象，应用人工全膝关节置换术进行治疗，对比分析治疗前后患者的膝关节股胫角、屈曲挛缩度、膝关节屈伸活动度与膝关节 HSS 评分的变化，同时进行随访，评估患者恢复一年后，下肢力线的恢复情况以及双下肢等长情况。结果经过手术的治疗及12个月的恢复，手术后患者膝关节股胫角、屈曲挛缩度和膝关节屈伸活动度分别为（18.0±5.8）°、（19.7±1.2）°和（42.2±17.5）°，与手术前相比较，[（168.9±2.6）°、（1.3±0.5）°和（147.3±22.7）°]，患者的膝关节股胫角和膝关节屈伸活动度均大幅提高，屈曲挛缩度大幅降低，差异具有统计学意义（ P ﹤0.05）。经过手术的治疗及12个月的恢复，患者的膝关节 HSS 临床评分和功能评分分别为（88.3±5.1）和（19.3±1.3）分，同术前相比[（31.2±10.1）分、（14.3±1.1）分]，均大幅提高，差异有统计学意义（ P ﹤0.05）。术后随访发现，患者并无下肢不等长、术后跛行和严重感染情况等并发症的发生。结论人工全膝关节置换术治疗单侧膝内翻合并屈曲挛缩畸形临床效果显著，患者术后膝关节股胫角、屈曲挛缩和膝关节 HSS 评分有显著改善，有效提高了患者的生存质量，值得在临床推广应用。
목적：탐토인공전슬관절치환술치료단측슬내번합병굴곡련축기형적림상효과，위림상치료제공의거。방법선택2009년6월지2014년6월수치적35례단측슬내번합병굴곡련축기형적환자위연구대상，응용인공전슬관절치환술진행치료，대비분석치료전후환자적슬관절고경각、굴곡련축도、슬관절굴신활동도여슬관절 HSS 평분적변화，동시진행수방，평고환자회복일년후，하지력선적회복정황이급쌍하지등장정황。결과경과수술적치료급12개월적회복，수술후환자슬관절고경각、굴곡련축도화슬관절굴신활동도분별위（18.0±5.8）°、（19.7±1.2）°화（42.2±17.5）°，여수술전상비교，[（168.9±2.6）°、（1.3±0.5）°화（147.3±22.7）°]，환자적슬관절고경각화슬관절굴신활동도균대폭제고，굴곡련축도대폭강저，차이구유통계학의의（ P ﹤0.05）。경과수술적치료급12개월적회복，환자적슬관절 HSS 림상평분화공능평분분별위（88.3±5.1）화（19.3±1.3）분，동술전상비[（31.2±10.1）분、（14.3±1.1）분]，균대폭제고，차이유통계학의의（ P ﹤0.05）。술후수방발현，환자병무하지불등장、술후파행화엄중감염정황등병발증적발생。결론인공전슬관절치환술치료단측슬내번합병굴곡련축기형림상효과현저，환자술후슬관절고경각、굴곡련축화슬관절 HSS 평분유현저개선，유효제고료환자적생존질량，치득재림상추엄응용。
Objective The present study evaluated the clinic effect of total knee arthroplasty in the treatment of unilateral knee versus with flexion contracture,thus providing the basis for clinic treatment. Methods The patients,who endure the unilateral knee versus with flexion contracture,were enrolled in the present study,and the sample included 35 cases. The study was carried on form June 2009 to June 2014. All the patients were treated by total knee arthroplasty. The contrastive analysis factors included knee joint tibiofemoral angle,knee flexion contracture, knee flexion mobility and the HSS score. In addition,the lower limb power line recovery and double lower extremities isometric conditions were e-valuated as a supplement with 1 year follow - up. Results The follow - up information of all patientsˋwere obtained for 1 - 3 years. The results suggested that the knee joint tibiofemoral angle,knee flexion contracture,knee flexion mobility of patients recovered form(18. 0 ± 5. 8)°,(19. 7 ± 1. 2)° and(42. 2 ± 17. 5)° to(168. 9 ± 2. 6)°,(1. 3 ± 0. 5)°and(147. 3 ± 22. 7)°,respectively. There was a statistical significance be-fore and after the treatment( P ﹤ 0. 05 ). On the other side,the HSS score and functional score increased from(31. 2 ± 10. 1)and(14. 3 ± 1. 1)to(88. 3 ± 5. 1)and(19. 3 ± 1. 3),respectively. There was a statistical significance before and after the treatment also( P ﹤ 0. 05 ). In ad-dition,the complications,such as limbs length discrepancy,postoperative limp and serious infections,were not observed in the follow - up date, which means that the surgery achieved a satisfactory curative effect. Conclusion As an efficient clinic method in the treatment of unilateral knee versus with flexion contracture,total knee arthroplasty exhibited a significant improvement in knee joint tibiofemoral angle,flexion contracture and knee joint HSS score,thus providing a higher life quality of the patients,which is deserved to be generalized in clinic.