中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (52): 9778-9781.doi: 10.3969/j.issn.1673-8225.2011.52.021

• 人工假体 artificial prosthesis • 上一篇    下一篇

后稳定或半限制性骨水泥型膝关节假体治疗僵硬膝：治疗前后关节活动功能的改变

褚亚明，周一新，李玉军   

  1. 北京积水潭医院，北京大学第四临床医学院矫形骨科，北京市100035
  • 收稿日期:2011-10-09 修回日期:2011-11-03 出版日期:2011-12-24 发布日期:2011-12-24
  • 通讯作者: 周一新，博士，副教授，北京积水潭医院，北京大学第四临床医学院矫形骨科，北京市100035 orthoyixin@yahoo.com
  • 作者简介:褚亚明☆，男，1978年生，博士，医师，主要从事复杂膝关节置换的治疗及其相关研究。 laochu2004@sina.com

Stabilized or semi-restrictive cemented prosthesis for treatment of stiff knees: Changes in joint function

Chu Ya-ming, Zhou Yi-xin, Li Yu-jun   

  1. Department of Orthopaedics, Beijing Jishuitan Hospital, the Fourth Clinical College of Peking University, Beijing  100035, china
  • Received:2011-10-09 Revised:2011-11-03 Online:2011-12-24 Published:2011-12-24
  • Contact: Zhou Yi-xin, Doctor, Associate professor, Department of Orthopaedics, Beijing Jishuitan Hospital, the Fourth Clinical College of Peking University, Beijing 100035, china orthoyixin@yahoo.com
  • About author:Chu Ya-ming☆, Doctor, Physician, Department of Orthopaedics, Beijing Jishuitan Hospital, the Fourth Clinical College of Peking University, Beijing 100035, china laochu2004@sina.com

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摘要：

背景：重度僵硬膝行膝关节置换的疗效还存在一定争议。
目的：探讨重度僵硬膝关节行人工全膝关节置换的临床效果。
方法：2007-06/2010-05于北京积水潭医院、北京大学第四临床医学院行人工全膝关节置换的僵硬膝患者221例，分为严重受限组(置换前膝关节活动度<65°)63例(99膝)，部分受限组(65°≤置换前活动度<90°)158例(230膝)，并随机选出同期手术的置换前活动度正常(≥90°)的患者202例(300膝)为对照组。
结果与结论：置换后所有患者的膝关节活动度、美国膝关节协会评分评分及西安大略麦马斯特大学骨性关节炎评分和置换前相比均有明显改善(P < 0.05)，置换后严重受限组较置换前增加的活动度和功能要明显高于部分受限组和对照组，且置换后部分受限组较置换前增加的活动度和功能要明显高于对照组，说明重度僵硬膝关节在关节置换后能得到很好的活动度和功能，置换前活动度越差，置换后活动度和功能的改善可能越明显。

关键词: 置换, 膝, 僵硬, 美国膝关节协会评分, 西安大略麦马斯特大学骨性关节炎指数

Abstract:

BACKGROUND: There is a contrary in outcome of knee arthroplasty in patients with severe stiff knees.
OBJECTIVE: To explore the outcome of artificial total knee arthroplasty in patients with severe stiff knees. 
METHODS: 221 patients with severe stiff knees performed total knee arthroplasty in Beijing Jishuitan Hospital, the Forth Clinical College of Peking University from June 2007 to May 2010 were involved. According to the preoperative range of motion (ROM), these patients were divided into two groups. Severe stiff group (ROM < 65°) included 63 patients (99 knees), and partial stiff group (65°≤ROM<90°) included 158 patients (230 knees). 202 patients (300 knees) had normal activity of the knee before arthroplasty at the same time were taken as control.
RESULTS AND CONCLUSION: As a result of the arthroplasty, the ROM, knee society score, and Western Ontario and Mcmaster Universitics Osteoarthritis Index score of all patients were improved than before (P < 0.05). The increased ROM and function after arthroplasty of the severe stiff group knees were significant greater than those of the partial stiff group and the control group, and that of the partial stiff group knees were significant greater than in the control group. The patients with severe stiff knees could gain good ROM and function after total knee arthroplasty. Improvements in mobility and function were greater in the cases with severe preoperative stiffness.

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