全膝关节置换术治疗膝骨性关节炎的临床效果

Clinical effect of total knee arthroplasty in the treatment of knee osteoarthritis

目的观察全膝关节置换术(TKA)对晚期膝骨性关节炎临床疗效和下肢力线的影响。方法对45例膝骨性关节炎患者(57膝)行TKA治疗,采用疼痛VAS评分、膝关节活动度(ROM)、KSS关节及功能评分对膝关节功能进行评价,采用SF-36评分对患者生活质量进行评价,摄双下肢全长片评估下肢力线。结果患者均获得随访,时间48～60(54±4)个月。1例术后5个月发生膝前痛,行股四头肌肌力锻炼后缓解。随访期间所有膝关节假体位置良好,未见骨溶解、假体松动或下沉。末次随访时,VAS评分、ROM、KSS关节及功能评分、SF-36评分、下肢力线与术前比较差异均有统计学意义(P<0.01)。结论 TKA是治疗晚期膝骨性关节炎的有效方法,可以缓解疼痛,纠正畸形,恢复下肢力线,改善关节功能,提高患者的生活质量。

Objective To observe the clinical effect and lower limb alignment of total knee arthroplasty（ TKA） on advanced knee osteoarthritis. Methods Forty-five patients with knee osteoarthritis of 57 knees underwent TKA were examined by VAS,ROM,KSS for knee function,and Short Form 36 Health Survey questionnaire（ SF-36） for life quality. Meanwhile,lower limb alignments were measured on standing long-leg radiograph film. Results The patients were followed-up for 48 ～ 60（ 54 ± 4） months. One case had anterior knee pain at 5 months after TKA,and resolved through quadriceps femoris exercise. There was no loosening,sinking or osotelysis and the position of the prosthesis during follow-up period. At the final follow-up,the VAS,ROM,KSS,SF-36 scores as well as lower limb alignment improved significantly than the preoperative（ P 0. 01）. Conclusions TKA can effectively relief pain,restore lower limb alignment,improve joint function and life quality for patients with severe osteoarthritis.