一期双膝关节置换术治疗严重骨关节炎的疗效

Therapeutic effects of one-stage bilateral total knee arthroplasty for treatment of severe knee osteoarthritis

目的探讨一期双膝关节置换术(BTKA)治疗严重骨关节炎的疗效。方法采用一期BTKA治疗30例双膝严重骨关节炎患者。对比治疗前后膝关节活动度、膝关节股胫角、屈曲挛缩度、疼痛VAS评分、膝关节KSS评分及WOMAC指数。结果患者均获得随访,时间18~79(36.2±5.4)个月。末次随访时,膝关节活动度和膝关节股胫角较术前均大幅提高,屈曲挛缩度较术前大幅降低,差异均有统计学意义(P<0.001);膝关节KSS临床评分和功能评分较术前均大幅提高(P<0.001);VAS评分、WOMAC指数较术前均大幅下降(P<0.001)。结论在严格把握手术适应证的前提下,一期BTKA治疗严重骨关节炎安全、有效,可获得满意的临床疗效。

Objective To investigate the efficacy of one-stage bilateral total knee arthroplasty(BTKA)for treatment of severe knee osteoarthritis.Methods Total 30 patients with severe knee osteoarthritis were treated by the one-stage BTKA method.The range of motion(ROM),femorotibial angle(FTA),flexion contracture,pain visual analogue scale(VAS),knee society score(KSS)and the Western Ontario and McMaster Universities Arthritis Index(WOMAC)were analysed between the preoperation and postoperation.Results All cases were followed up for 18~79(36.2±5.4)months.At the last follow-up,ROM and FTA were both significantly improved,the flexion contracture was significantly decreased,and there were statistical significances(P<0.001).In addition,the KSS clinical score and KSS functional score were significantly increased,compared with the preoperative(P<0.001),the VAS and WOMAC were significantly decreased,compared with the preoperative(P<0.001).Conclusions On the premise of strictly mastering the indications of surgical adaption,one-stage BTKA in treatment of severe knee osteoarthritis is safe and effective,clinical curative effect is satisfactory.