全膝置换术治疗晚期血友病性膝关节炎疗效分析

Total knee replacement for the treatment of anaphase hemophilic arthropathy

目的：探讨全膝置换术治疗晚期血友病性膝关节炎的临床疗效。方法：采用全膝置换术治疗晚期血友病性膝关节炎5例6膝，按Arnold分期，Ⅲ期1例，Ⅳ期4例；年龄34—47岁，平均39岁。对手术前后关节的HSS评分（the hospital for special surgery knee score，HSS）、疼痛和活动度进行随访比较。结果：所有患者均获随访，随访时间11—46个月（平均25个月），术前HSS评分平均为19分（1l一37分），术后平均为73分（62—81分）。5膝疼痛缓解，4膝屈曲挛缩明显缓解，活动度轻度改善。1膝术后疼痛早期有缓解，4个月后膝关节再次出血后疼痛复发，活动度丢失。结论：在一定的诊疗条件保障下全膝置换术能缓解晚期血友病性膝关节炎的疼痛和改善膝关节功能，是一种安全有效的治疗方法。

Objective：To explore the effects of anaphase hemophilic arthropathy with total knee replacement. Methods：Five patients （6 knees） of anaphase hemophilic arthropathy were treated with total knee replacement. According to Arnold staging：there were 1 grade Ⅲ and 4 grade Ⅳ. The average age were 39 years old （range from 34 to 47 ）. According to HSS score, pain and range of motion （ROM） were compared before and after operation. Results： All the patients were followed up from 11 to 46 months with the average of 25 months. According to scoring HSS system：the preoperative average was 19 （11 -37 ）and the postoperative average was 73 （62 -81 ）. Pain remission occured in 5 knees. Flexion contractures and ROM of joint obtained amelioration in 4 knees. The pain in earlier period had relief in 1 knee,of which ROM losed and pain relapse caused by bleeding in the 4 months after operation. Conclusion：Total knee replacement is a safe and effective method to anaphase hemophilic arthropathy. The method can relieve pain and improve joint funation if the hospital provided with safe diagnosis and treatment condition.