膝关节Charcot关节病全膝关节表面置换术的手术疗效

Total knee arthroplasty in Charcot arthritis patients

目的总结膝关节Charcot关节病患者全膝关节表面置换术（TKA）的手术疗效。方法对2000年9月至2007年1月施行的4例Charcot关节病患者5个膝关节施行TKA的手术疗效进行回顾分析。4例患者中，男性2例，女性2例，手术时年龄64～72岁，平均67．3岁。2例行单膝TKA，1例行一次麻醉下双膝关节同时置换术，1例在同一次麻醉下行髋膝关节同时置换术。术前KSS评分平均33．75分。结果随访19～96个月，平均65个月。5个膝关节均无感染及松动，术后KSS评分平均95．25分，患者对功能及关节的稳定性满意。结论对Charcot关节病施行TKA的中期随访结果基本满意；选择适当的膝关节表面置换假体和重视手术操作可能与手术后效果密切相关。

Objective To discuss the results of total knee arthroplasty undertaken for Charcot arthritis patients. Methods Between September 2000 and January 2007,4 consecutive patients （2 men and 2 women; 5 TKAs） with Charcot arthritic knees were treated. At the time of surgery, the mean age of the patients was 67. 3 years （64 to 72 years）. One had bilateral and 2 had unilateral TKA and one had ipsilateral total hip and total knee arthroplasty. The mean knee society score before operation was 33.75 poits. Results The mean follow-up was 65 months （ 19 to 96 months ）. The mean knee society score post-operation had improved to 95.25 points in 5 TKAs with no occurrence of infection and loosening. All 4 patients were very satisfactory with the clinical results at the last follow-up. Condusions The midterm follow-up data indicated that total knee arthroplasty to treat Charcot arthritis could get good clinical results. The postoperational results in Charcot arthritis were closed related with the proper prosthesis and surgical technique.