PSKA治疗重症类风湿性关节炎(RA)的疗效分析

The evaluation of posterior stabilized knee arthroplasty for patients of rheumatoid arthritis with knee flexion contracture

目的探讨后方稳定型全膝人工关节置换术(posterior stabilized knee arthroplasty,PSKA)治疗重症类风湿性关节炎(rheumatoid arthritis,RA)膝关节屈曲挛缩畸形的临床应用价值。方法回顾性分析2000年-2006年收治的31例(62膝)重症RA膝关节屈曲挛缩畸形患者行PSKA手术的疗效。结果31例均得到术后随访,术后膝关节HSS评分由术前的平均24.3分增加至平均84.4分,其中优:19例(61.3%,85-92分);良:8例(25.8%,71-83分);可:4例(12.9%,61-68分);差:0例;术后优良率达87.1%。且术后在疼痛、关节活动度及稳定性方面均有明显改善。结论PSKA是治疗重症RA膝关节屈曲挛缩畸形的有效方法,可使病人术后获得膝关节屈曲畸形的矫正、活动度增加和良好的稳定性。

Objective To evaluate the mid-term results of posterior stabilized knee arthroplasty（PSKA） for the patients of rheumatoid arthritis（RA） with flexion contracture.Methods From 2000 to 2006,31 patients of RA aged 49-76 years old（7 males,24 females） with knee flexion contracture underwent primary PSKA.Results All patients were followed-up after operation.The HSS score of knee improved from 24.3 to 84.4 on average.19 patients were rated as excellent,8 good,4 fair,and 0 poor.The excellent and good rate was 87.1%.Every patient have conspicuous amendment in pain、stability and joint range of motion.Conclusion PSKA is an effect management for the patients of RA with flexion contracture.The proper PSKA can not only achieve an obvious correction of the flexion contracture but also effectively improve the range of motion and the stability of joint.