影响全膝关节置换术后关节活动度的相关因素分析

Influence factors of range of motion after total knee arthroplasty

目的分析全膝关节置换术后关节活动度的相关影响因素，旨在探讨如何提高术后膝关节活动范围。方法回顾性研究2008年10月～2010年10月37例全膝关节置换术。术后1年25例膝关节屈曲度〉90。的患者作为对照组，12例膝关节屈曲度〈90。的患者作为实验组。两组根据年龄、性别、体重指数（BMI）、手术时间、术中出血和随访时间等进行配对病例对照研究分析影响因素。结果两组患者年龄、性别、手术时间、术中出血、随访时间及术前合并症比较，差异无统计学意义。手术前后两组膝关节屈曲度比较，差异有显著统计学意义（P〈O．01）。手术前后两组的胫骨倾斜度与关节力线对位不良的比较，差异有统计学意义（P〈O．05）。结论全膝关节置换术后膝关节活动度受肥胖、下肢力线对位情况和术后主动功能锻炼等因素影响，术中术后减少以上因素影响可以提高膝关节术后活动度。

Objective To analyze the related factors of the range of motion（ROM） after total knee arthroplasty and discuss how to improve the ROM of knee. Methods A retrospective review was given to the data from 37 patients undergoing total knee arthroplasty between October 2008 and October 2010. There＇re 25 TKA patients with greater than 90 flexion at 1 year postoperative served as control group, 12 patients with a 1-year postoperative flexion range of less than 90~ was taken as treatment group. The age, sex, body mass index, time for surgery,intraoperative bleeding,follow-up time of the control group were matched to those of the treatment group. Results No significant differences were found with regard to the age,sex,body mass index, time for surgery, intraoperative bleeding,follow-up time. Significant differences were found between preoperative flexion and postopeartive flexion （P 〈0.01）. Preoperative and postoperative the gradient of tibial and force line of lower extremities were significantly correlated with postoperative ROM （P 〈0.05）. Conclusion Influence factors of the ROM after TKA include obesity, force line of lower extremities, active exercise after operation. Once avoiding the above factors, you can improve the ROM of joint.