256个人工全膝关节置换术的临床体会

The Experience of Total Knee Arthroplasty Used in 256 Knees

目的:回顾分析总结人工膝关节表面置换术的适应证、手术技巧、康复方法及疗效。方法:选取206例(268膝)人工全膝关节置换术患者。对术前和随访时患者的HSS评分、膝前痛评分、功能评分、膝关节活动度等进行对比和分析。结果使用SPSS18.0统计软件进行统计学分析。结果:实际随访到的199例(256膝),平均随访(31±11.65)个月,膝关节HSS评分从术前平均HSS评分(40.33±12.02)分增加到随访时的平均(87.28±10.13)分,优良率为92.8%。疼痛评分从术前的平均(13.15±3.32)分增加到随访时的平均(25.40±6.51)分。功能评分从术前的平均(8.46±2.18)分增加到随访时的平均(17.82±3.82)分。疼痛完全缓解率88.67%(227/256),85.61%(170/199)的患者对治疗效果满意。结论:人工膝关节置换是治疗终末期膝关节疾病的有效手段。在进行手术时应严格掌握适应症,规范术中和术后处理,重视术后康复锻炼,方能显著提高临床效果,改善患者生活质量,减少并发症。

Objective： To evaluate the indications, operation techniques, rehabilitation approach and clinical effects of total knee arthroplasty （ TKA ） .Method： 206 patients （ 256 knees ）with total knee arthroplasty were followed-up. HSS knee scores, anterior knee pain scores, function scores, range of motion （ ROM ） were compared and analyzed from preoperatively to final followed-up postoperatively. The data were analyzed using SPSS 18.0 software.Result： Out of 206 cases （ 268 knees ）, 199 cases （ 256 knees ） had been followed up for an average of （ 31 ± 11.65 ） months. Knee HSS, anterior knee pain scores and function scores increased respectively from （ 40.33± 12.02 ）, （ 13.15 ± 3.32 ） and （ 8.46± 2.18 ） scores preoperatively to （ 87.28 ± 10.13 ）, （ 25.40 ±6.51 ） and （ 17.82 ± 3.82 ） scores postoperatively. The excellent and good rate in Knee HSS after TKA was 92.8%.Tbe complete remission rate of pain was 88.67%, and 85.61% patients after the operation are satisfied.Conclusion： TKA is an effective technology to treat end-stage knee joint disease. At operation, the surgical indication should be strictly controlled, intraoperative and postoperative management must be standardized, postoperative exercise oughted to be strengthened. Only in this way, the efficacy of clinical treatment and the quality of life of patients could be improved, and complications reduced.