保留关节囊滑膜的钛合金人工膝关节随访观察

Long-term Functional Observation of Artificial knee Joint Replacement with Preserved Capsule and Synovia

通过对29例保留关节囊及滑膜组织的钛合金铰链式人工膝关节置换病人的随访观察,作者发现有41.3％的病人关节活动痛,45％需持拐行走,所有病例均有肌萎缩,膝关节屈伸均小于90°。作者还对5例再手术及2例术后再截肢的关节作了大体和组织学观察,认为关节活动痛及屈曲受限的原因与关节囊及滑膜增厚、纤维结缔组织增生的病理改变有关,指出此病理改变的原因为金属离子的刺激所致,建议术中切除关节囊和滑膜,提出改进人工膝关节研制的设想。

Long-term observation of joint pain .articular function, joint movement and deformity in 23 cases who received domestic titanial alloy hinge artificial knee joints showed .finding that joint moving pain in 41. 3%,muscular atrophy in 100%.45% of the cases needed the stick when walking and the range of flexion and extension was between 0°-90°,The author considered that the causes of artificial joint pain and limited movement were due to its structure and approved by the sample biopsies from 5 reoperated cases and 2 amputed cases following artificial knee joint. The capsule is thickened to 0. 5-1.0cm ,black -stained .hard and contracted ;the synovium is also thickened .protruded.band-like .inelastic and growing into articular cavity extensively. The pathological examination revealed fiber connective tissue. The author pointed out that the cause of the pathological change is due to the stimulation of metal ion and suggested a new design to improve the function of artificial knee joint.