全膝关节置换术中注射鸡尾酒式镇痛混合剂对膝关节中期功能的影响

Effect of intra-articular cocktail analgesic mixture injection on midterm knee function after total knee arthroplasty

目的评价全膝关节置换（TKA）术中注射鸡尾酒式镇痛混合剂对膝关节中期功能和屈伸活动度的影响。方法笔者自2006-05—2007-05诊治80例行单侧全膝关节置换的膝关节骨性关节炎,随机分为试验组和对照组,对比2组术后中期随访时美国膝关节协会（KSS）评分和膝关节活动度（ROM）的差异。结果 64例获随访45-69个月,平均61个月,试验组有效随访31例,对照组有效随访33例。试验组KSS评分（91.9±4.4）分,屈膝角度（129.2±6.9）°,伸膝角度（0.5±1.2）°;对照组KSS评分（87.5±4.9）分,屈膝角度（121.5±7.1）°,伸膝角度（0.3±1.1）°,试验组KSS评分及主动屈膝活动度指标优于对照组,2组KSS评分（t=3.77,P=0.001）、主动屈膝活动度（t=4.40,P=0.001）比较差异有统计学意义,主动伸膝活动度2组比较差异无统计学意义（t=0.70,P=0.492）。结论鸡尾酒式镇痛混合剂改善TKA术后膝关节中期功能效果显著。

Objective To evaluate the midterm follow-up results of KSS score and knee ROM after intra-articular cocktail analgesic mixture injection in total knee arthroplasty. Methods A total of 80 patients with knee osteoarthritis undergoing unilateral TKA from May 2006 to May 2007 were equally randomized and assigned to the experimental group and control group. The midterm KSS score and knee ROM of the 2 groups during the outpatient follow-up were compared. Results Sixty four patients were effectively followed up and the median follow-up time was 61 months（range from 45 to 69 months）, 31 patients in experimental group and 33 in control group. Initiative ROM of flexion of experimental group was（129.2±6.9）° and ROM of extension was（0.5±1.2）°, KSS score was（91.9±4.4）; Initiative ROM of flexion of control group was（121.5±7.1）°,ROM of extension（0.3±1.1）° and KSS score（87.5±4.9）. Difference of KSS score（t =3.77, P =0.001） and initiative ROM of flexion（t =4.40, P =0.001） were significant between 2 groups, there was no significant difference of initiative ROM of extension（t =0.70, P =0.492）. Conclusion Intra-articular cocktail analgesic mixture injection contributes to the knee function during a midterm followup and patients benefit.