高屈曲体位下缝合对20例全膝关节置换术术后功能恢复的影响

Effect of suture under high flexion position on functional recovery after total knee arthroplasty in 20 cases

[目的]观察高屈曲体位下缝合对全膝关节置换术(TKA)术后膝关节功能恢复的影响.[方法]选择2017年9月至2019年8月间诊断为膝关节骨性关节炎及类风湿性关节炎并接受TKA的患者41例,其中将2017年9月至2018年10月间收入的21例纳入A组(行膝关节屈曲90°下膝关节缝合),2018年10月至2019年8月间收入的20例纳入B组(行膝关节屈曲130°~155°下膝关节缝合).所有患者术后均随访6个月及以上.应用VAS疼痛评分评估术前、术后1、3、7 d及术后1个月时的疼痛程度;采用HSS膝关节评分评估术前、术后7 d及术后1、3、6个月时的膝关节功能;独立记录术前、术后1、7 d及术后1、3、6个月时的膝关节活动度(ROM).[结果]术后1、3 d时B组VAS评分明显低于A组(P<0.05),术后7 d及1个月时两组VAS评分间无明显差异(P>0.05).术后7 d及1、3个月时B组HSS评分明显高于A组(P<0.05),术后6个月时两组HSS评分间无明显差异(P>0.05).术后1、7 d及术后1个月时B组ROM值明显高于A组(P<0.05),术后3、6个月时两组ROM值间无明显差异(P>0.05).[结论]高屈位缝合对行TKA患者术后早期功能恢复具有较好的效果,可有效缓解患者早期练习痛,提高患者满意度.

OBJECTIVE To observe the effect of suture under high flexion position on the functional recovery of knee joint after total knee arthroplasty(TKA).METHODS A total of 41 patients diagnosed with knee osteoarthritis and rheumatoid arthritis and receiving TKA between September 2017 and August 2019 were selected.Among them,21 patients received from September 2017 to October 2018 were included in group A(knee joint suture at 90°of knee joint flexion),and 20 patients received from October 2018 to August 2019 were included in group B(knee joint suture at 130°-155°of knee joint flexion).All patients were followed up for 6 months or more after surgery.VAS pain score was used to evaluate the degree of pain before surgery,1,3,7 days and 1 month after surgery.HSS knee score was used to evaluate knee function before surgery,7 days after surgery,and 1,3 and 6 months after surgery.The range of motion(ROM)of the knee joint were separately recorded before surgery,1 day and 7 days after surgery,1,3,and 6 months after surgery.RESULTS VAS score of group B was significantly lower than that of group A 1 day and 3 days after surgery(P<0.05),while there was no significant difference in VAS scores between the two groups at 7 days and 1 month after surgery(P>0.05).The HSS score of group B was significantly higher than that of group A at 7 days,1 month and 3 months after surgery(P<0.05),and there was no significant difference in HSS score between the two groups at 6 months after surgery(P>0.05).The ROM value of group B was significantly higher than that of group A at 1 day,7 days and 1 month after surgery(P<0.05),while there was no significant difference in ROM values between the two groups at 3 and 6 months after surgery(P>0.05).CONCLUSION High-flexion suture has a good effect on early postoperative functional recovery after TKA,which can effectively alleviate the early exercise pain of patients and improve patient satisfaction.