全膝关节置换术后高屈曲活动度对改善患者生活质量的作用

To investigate the effect of knee high flexion motion after total knee arthroplasty on the life quality of patients

目的 探讨全膝关节置换术（TKA）后膝关节高屈曲活动度在改善患者生活质量中的作用.方法 我院骨科行单侧全膝关节置换术的患者68例,术后随访24～ 36个月,平均随访时间30.3个月,将术后随访时的关节活动度,以130＆#176;为界点分为高屈曲组（≥130＆#176;）共30例与对照组（＜130＆#176;）共38例.根据患者术前与术后关节活动度、纽约特种外科医院膝关节评分（HSS）关节功能评分及术后健康调查简表（SF-36）等数据结果,使用SPSS 18.0统计软件分析.结果 高屈曲组的关节功能、活动度、HSS评分平均值分别为（16.8±3.6）、（17.1±0.3）、（90.9±6.6）分,高于对照组[（14.3±3.0）、（15.3±1.2）、（86.4±5.4）分,P＜0.05].SF-36中生理功能和社会功能评分分别为（75.3±15.5）、（75.0±10.6）分,明显高于对照组[（60.4±19.0）、（57.6±29.3）分,P＜0.05].术后屈曲度≥130＆#176;组的患者满意度高达96.7％.结论 TKA术后膝关节高屈曲活动度功能在改善患者膝关节功能和生活质量中具有重要作用.

Objective To investigate the effect of high flexion motion range of knee on patients＆#39; improvement of life quality compared with non-high flexion knee function after total knee arthroplasty （TKA）.Methods 68 patients were followed up who received unilateral total knee arthroplasty at our hospital,By the time of the follow up of short-term results of 24-36 months after TKA,30.3 months on average.the patients were divided into high flexion group （≥130＆#176;） 30 patients and control group （〈 130＆#176;） 38 patients by the critical point 130＆#176; of range of flexion.Then we compared the collected data of motion range of knee flexion,Hospital for special surgery knee socre （HSS） joint function score before and after operation,and postoperative the MOS item short from health survey （SF-36） life quality score by using designed questionnaire and statistical analysis.Results The average scores the high flexion group in function,mobility,HSS score which was 16.8 ±3.6,17.1 ±0.3,90.9 ±6.6,higher than the control group （14.3 ±3.0,15.3 ± 1.2,86.4 ±5.4,P 〈0.05）.Comparing the items of SP-36,the scores of the high flexion group in biological function and social function which was 75.3 ± 15.5,75.0 ± 10.6,significantly higher than the control group （60.4 ± 19.0,57.6 ± 29.3,P 〈 0.05）.The patients of high flexion group （≥130＆#176;） had highest satisfaction rate which was 96.7% after the operation.Conclusion The postoperative TKA patients of high flexion motion range of knee got the better joint function,life quality and satisfaction rate than the control.