严重畸形膝骨关节病的人工膝关节置换术

Total knee replacement in patients with severe knee deformity

目的探讨严重畸形的膝骨关节病在行关节置换手术治疗过程中需要注意的问题,以及具体的手术操作注意事项。方法总结分析了本组采用全膝关节置换治疗严重畸形的膝骨关节病共57例,随访33例52膝的临床资料。结果随访病例应用美国HSS评分系统,满分100分。85分以上为优;70～84分为良;60～69分为尚可;60以下为差。随访的全部病例中14例21膝为优,16例26膝为良,3例5膝为尚可,优良率90.38%,满意率96.15%。结论全膝关节置换术治疗严重畸形的膝关节病变时存在一定的难度,但是通过正确的截骨及软组织平衡也可以达到满意的效果。

Objective To investigate the methods and clinical results of total knee replacement （TKA） in patients with severe knee deformity. Methods There were 57 severe knee deformity cases were performed with TKA in this group and 33 cases （52 knees） of them were followed-up. Results All the 33 cases （52 knees ） were evaluated by Hss score. The clinical effect was excellent （ 〉 85） in 14 cases （53 knees）, good （70 - 84） in 16 cases （26 knees）, fair （60 - 69） in 3 cases（5 knees）, no poor （ 〈 60）. The excellent and good rate was 90.38%. The satifactory rate was 96. 15%. Conclusions There are much difficulty in the TKAs with severe knee deformity, but standard osteotomy and soft tissue balance still can correct severe knee deformity very successfully in patients undergoing primary total knee replacement, and provide excellent results.