人工全膝关节置换治疗严重类风湿性关节炎和骨性关节炎12例体会

12 Cases about Artificial Total Knee Arthroplasty in the Treatment of the Serious Rheumatoid Arthritis and Osteoarthritis

目的探讨人工全膝关节置换术手术要点及术后疗效.方法对我院2001年3月～2002年12月行人工全膝关节置换术的9例老年膝关节骨性关节炎和3例严重类风湿性关节炎患者进行回顾性分析.结果按美国的HSS评分系统进行评定,术前平均分为41.0分,最后随访时平均分为87.7分.优:6例,良:4例,可:2例.术后在疼痛、关节功能及活动度等方面均有明显的改善,膝关节能完全伸直,肌力及稳定性均有所增加.患者均无感染、深静脉血栓形成及膝关节脱位等并发症.结论人工全膝关节置换术治疗严重类风湿性关节炎和骨性关节炎疗效可靠,手术技术要求高,术前熟悉器械、仔细测量、术后预防并发症及正确的康复锻炼对临床疗效至关重要.

Objective To study the key point and curative effect of total knee arthroplasty for the treatment of the serious rheumatoid arthritis and osteoarthritis.Methods 9 cases osteoarthritis and 3 cases serious rheumatoid arthritis treated by total knee arthroplasty between March 2001 and December 2002 were analysed retrospectively.Results According to the HSS scoring system,the average scores were 41 preoperatively and 87.7 postoperatively.Therefore,the excellent,good and normal cases were 6,4 and 2 respectively.Pain,joint function and activity were ameliorated transparently after operation.The knees all can be straightened,muscle power and stability were also enhanced.All patients had no complications of infection,deep venous thrombosis and knee joint dislocation.Conclusion Total knee arthroplasty shows good clinical effect.Demanding the higher technology,familiarizing the instrument,measuring pre-operation carefully and preventing the complication,correct rehabilitating post-operation are very important to the clinical curative effect.