中西医结合在人工全膝关节置换术中的应用

Experience of application of combined Chinese traditional and western medicine on total knee arthroplasty

目的探讨五合一截骨法行全膝关节置换术(TKA)的疗效、术后并发症及术后中医特色的康复锻炼。方法应用五合一截骨法施行全膝关节置换术38例42膝,术前、术后4周和12周进行膝关节评分法(HSS)评分,并测量膝关节活动度(ROM)。结果术前HSS评分平均30.8分,术后4周和12周HSS评分分别平均为83.4分和92.2分;膝关节活动度:术前56.69°,术后4周增至101.14°,12周为115.79°。术后2周内无发生深静脉血栓、未出现感染、骨折、脱位等并发症。结论五合一截骨可明显缩短手术时间,提高手术准确率,是治疗重度膝关节疾病的有效方法,术后早期实施中医特色的康复锻炼安全可行,可使关节功能早期恢复,并可预防并发症的发生。

Objective To probe into the therapeutic effects,post-operative complications,and post-operative TCM-characteristic rehabilitation training on total knee arthroplasty（TKA）.Methods TKA operations were implemented in 42knees of 38 clients with severe osteoarthritis.HSS and ROM evaluation were given before operation,4 and 12 weeks after operation respectively.Results HSS score was 30.8 in average before operation,83.4 four weeks after operation,and 92.2 eight weeks after operation.ROM was 56.69 before operation,101.14 four weeks after operation,115.79 eight weeks after operation.There were no complications such as Deep Vein Thrombosis（DVT）,infections,fractures,and dislocations occur two weeks after operation.Conclusion Five-in-one osteotomy is able to shorten the operative time,Improve the accuracy,is one of the most effective methods to treat severe knee disorders.