全膝关节置换术治疗晚期类风湿性关节炎的早期临床疗效研究

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1、提要目的：研究全膝关节置换术(TotalKneearthroplasty,TKA)治疗晚期类风湿性关节炎的早期临床疗效。方法：对我院2010年3月-2012年2月共24例（30膝）严重的类风湿性关节炎患者行全膝关节置换术。对其临床资料进行总结、分析，经过定期随访，根据膝关节活动度的测量、膝关节HSS评分以评价手术效果。本组病例全部选用后稳定型假体，术中均未采用髌骨置换。手术后随访时对患者的膝关节进行评分，随访3-27月，平均随访约12月。结果：获得随访的患者膝关节活动度从术前平均（80.56±19.25）°改善到术后平均（

2、104.70±16.64）°。术前HSS评分平均为（47.6±13.1）分，术后HSS评分平均为（84.2±14.2）分；根据HSS评分系统评定疗效：优24例，良6例。术后出现刀口延迟愈合者2例，其余患者未出现其他并发症。随访X线片示假体位置、下肢力线良好，未见有假体周围透亮区出现。结论：对于符合TKA手术标准的晚期类风湿性关节炎患者可行膝关节置换手术治疗，可以取得比较满意的早期临床疗效，长期疗效还需进一步观察。关键词类风湿性关节炎膝关节全膝关节置换术临床疗效Thepreliminaryclinicaloutcomeoft

3、otalkneearthroplastyinthetreatmentofadvancedrheumatoidarthritisSpeciality：OrthopaedicsofTCMAuthor：LiuQiangTutor：QiuHongmingAbstractObjective:Toinvestigatethepreliminaryclinicaloutcomeoftotalkneearthroplastyinthetreatmentofadvancedrheumatoidarthritis.Method:Inhospi

4、talfromMarch2010toFebruary2012,atotalof24patients(30knees)withrheumatoidarthritisunderwenttotalkneearthroplasty.Allpatientsweretreatedwithposteriorstabilizedtotalkneesystemandwithoutpatellarreplacement.Allofthemhadbeenfollowedupforaverage12months(3-27months).Clini

5、calresultswereevaluatedpreoperativelyandpostoperativelyusingHSSscoringsystem,andtherangesofmotionweremeasured．Result:Therangesofmotionoftheirkneeswereaverage80.56±19.25degreespreoperatively,andaverage104.70±16.64degreespostoperatively.Themeanvalueofthescoresaccord

6、ingtoHSSwasaverage47.6±13.1preoperatively,andaverage84.2±14.2postoperatively.AccordingtoHSS,theresultswereexcellentin24cases,goodin6.Wounddelayedhealingin2casesafteroperation,theremainingpatientshadnoothercomplications.AlltheX-rayfilmsofthekneesimplantedwereanalyz

7、ed.Nomal-alignmentorlucentlinewiththeprosthesiswasseeninalltheseX-rayfilms．Conclusions:Thepreliminaryclinicaloutcomeoftotalkneearthroplastyinthetreatmentofadvancedrheumatoidarthritisissatisfactory,whilelongtermfollow-upisneeded.Keywordrheumatoidarthritis；knee;tota

8、lkneearthroplasty;clinicaloutcome目录引言...................................................................................................................