CR假体在TKA治疗伸直型膝关节僵硬的中短期疗效观察

The Short-term and Medium-term Efficacy of CR Prosthesis in the Treatment of Straightened Knee Ankylosis with TKA

目的探讨CR假体在TKA治疗伸直型膝关节僵硬的中短期疗效。方法回顾2014年3月至2018年12月共54例因伸直型膝关节僵硬而行膝关节置换术患者。其中CR组26例(30膝),PS组28例(30膝)。记录两组患者术前术后膝关节活动度、膝关节最大屈曲度、术后并发症。随访期间采用疼痛视觉模拟评分、患者满意度评分和纽约特种外科医院膝关节评分。结果术后平均随访26月(12~52月)。膝关节活动度CR组由术前(29.267±8.416)°提升至末次随访(73.933±14.943)°,P=0.01;PS组由(31.100±8.644)°提升至(71.433±13.843)°,P<0.001;术前膝关节最大屈曲度CR组由(34.867±12.087)°提升至(78.567±12.550)°,P<0.001,PS组由(32.133±10.846)°提升至(80.100±13.596)°,P<0.001。膝关节HSS评分CR组由术前(42.500±11.292)分提升至(76.467±6.135)分,P<0.001;PS组由(39.433±8.467)分提升至(74.500±6.683)分,P<0.001。CR组中有1例术后腓静脉肌间静脉血栓,PS组发生1例腓总神经损伤。结论 CR假体在TKA治疗伸直型膝关节僵硬是可行的,中短期疗效和PS假体相近,但和PS假体相比,满意度更高。

Objective To investigate the medium-and short-term efficacy of CR prosthesis in the treatment of straightening knee ankylosis with TKA. Methods From March 2014 to December 2018, a total of 54 patients who underwent the knee arthroplasty due to the extension knee stiffness were reviewed. There were 26 cases in CR group(30 knees) and 28 cases(30 knees)in PS group. The range of motion of knee joint, the maximum flexion of knee joint and postoperative complications were recorded in the two groups before and after the operation. Visual analogue scale of pain,patient satisfaction score and knee joint score of New York Special Surgery Hospital were used during the follow-up period. Results During the average follow-up of 26 months(12 ~ 52 months),the range of motion of knee joint increased from(29.27 ±8.42) °to(73.93 ±14.94) °in CR group, from(31.10 ±8.64)°to(71.43 ±13.84) °in PS group, and from(34.87 ±12.09) °to(78.57 ±12.55) °in CR group, and from(32.13 ±10.84) °to(80.10 ±13.60) °in PS group. The HSS score of knee joint increased from(42.50 ±11.29)to(76.47 ±6.13)in CR group and from(39.43 ±8.47)to(74.50 ±6.68)in PS group. There was 1 case of peroneal vein intermuscular vein thrombosis in CR group and 1 case of common peroneal nerve injury in PS group.Conclusion CR prosthesis is feasible in the treatment of knee ankylosis with TKA. The short-term and medium-term efficacy of PS prosthesis is similar to that of PS prosthesis,but its satisfaction is higher than that of PS prosthesis.