23例双侧同期人工膝关节置换临床疗效分析

Clinical effect analysis of bilateral simultaneity TKA in 23 patients

目的探讨行双侧同期人工全膝关节置换术(TKA)治疗双侧膝关节疾患的临床疗效。方法选择2005年3月至2009年1月23例双侧同期人工膝关节置换术病例,其中骨性关节炎18例,类风湿关节炎5例。23例均获得随访,随访时间12～56个月,平均38个月,采用纽约特种外科医院膝关节评分标准(HSS)评定临床疗效[1]。结果术前评分平均31分,术后平均89.4分;关节活动范围(range of motion,ROM)术前平均76°,术后平均105°;手术效果评定:优34膝(73.9%),良9膝(19.6%),可3膝(6.5%),差0膝,手术优良率93.5%。所有患者术后在疼痛、关节功能、活动度、畸形及稳定性方面均有明显改善,无一例发生感染。结论双侧同期人工膝关节置换术是治疗双侧膝关节疾患的有效方法,临床疗效显著,并发症的发生率亦无明显增加。

Objective To investigate the clinical effect of bilateral simultaneity TKA inthe treatment of bilateral knee joint diseases. Methods 23 patients were treated by bilateral simultaneity TKA between March 2005 and January 2009,which consist of 18 cases of osteoarthritis and 5 cases of rheumatoid arthritis. 23 patients were followed up for 12 to 56 months,average of 38 months,to evaluate the clinical effect according to HSS score system. Results The average scores were 31 preoperatively and 89. 4 postoperatively,the average rang of motion was 76°preoperatively and 105°postoperatively,the operation effects were excellent in 34 knees （ 73. 9%） ,good in 9 knees（ 19. 6%） ,normal in 3 knees（ 6. 5%） and poor in 0 knee,the excellent good rate was 93. 5%. The patients＇ pain,joint function,activity,abnormality and stability were improved transparently after operation. All patients had no complications of infection. Conclusion The bilateral simultaneity TKA is a effective method in treating bilateral knee joint diseases,which has prominent clinical effect,the rate of compli-cations is no evidently increasing,too.