旋转平台型膝关节假体置换治疗膝关节骨关节炎的疗效观察

Clinical experience of rotating-platform knee prothesis for the treatment of knee osteoarthritis

[目的]观察采用旋转平台型膝关节假体置换治疗膝关节骨关节炎(osteoarthritis,OA)的疗效。[方法]回顾性分析2007年3月～2009年8月收治的37例(48膝)严重膝关节OA患者,采用旋转平台型膝关节假体(美国强生公司))进行全膝关节置换(total knee arthroplasty,TKA),比较术前术后患者患侧膝关节HSS评分及膝关节活动度,观察术后并发症。[结果]37例患者中32例(42膝)患者获得满意随访,随访时间为10～48个月,平均随访22.6个月,本组病例手术切口均一期愈合,未发生关节脱位。1例术后1个月发生皮下浅表感染,给予分层穿刺,敏感抗生素治疗;1例术后3 d静脉血栓形成,给予低分子肝素抗凝治疗,均治愈。术前患者HSS评分为37～46分(平均43.27分),术后为73～96分(平均87.22分);术后膝关节活动度为112°～128°(平均117.52°),明显高于术前的40°～90°(平均63.25°),差异具有统计学意义(P﹤0.01)。[结论]旋转平台型假体置换治疗膝关节骨关节炎疗效满意,是治疗严重膝关节骨关节炎的有效方法。

[Objective] To analyze the curative effect of rotating-platform knee prothesis for the treatment of knee osteoarthritis（OA）. [Methods]Since March 2007 to August 2008,A total of 37 patients（48 knees） were selected because of the disesse of severe OA.All the patients received the TKA using rotating-platform knee prothesis from Johnson Johnson company of America.The clinical results of preoperation and postoperation were evaluated by the HSS knee rating score system and we compared the range of motion and monitored the complications. [Results]Only 32 patients（42 knees） were followed up for 10 months to 48 months（mean 22.6 months）.All incisions healed at one-stage and no dislocation occured.One infection and one deep vein thrombosis were founded and were cured by taking some relative treatment.The mean preoperative HSS of 43.27（range,37～46） improved to 87.22（range,73～96） postopertively.The result of T chest was P﹤0.01.The range of knee joint movement were 112°～128°afte operation,higer than in preoperative time（40°～90°）. [Conclusion]The short-term results of rotating-platform knee prothesis for the treatment of knee osteoarthritis are satisfactory.It is an effective method for the treatment of severe knee osteoarthritis.