人工全膝关节置换术后屈曲受限的影响因素分析

Analysis of Influencing Factors of Flexion Limitation after Artificial Total Knee Arthroplasty

目的:探讨人工全膝关节置换术后屈曲受限的影响因素。方法:选取2018年2月—2020年6月于南阳市骨科医院行全膝关节置换术的86例膝关节炎患者作为研究对象。术后随访半年统计术后膝关节屈曲情况,分为屈曲良好组(屈曲活动度≥90°)和屈曲受限组(屈曲活动度<90°),进行人工全膝关节置换术后屈曲受限的单因素分析及多因素logistic回归分析。结果:86例膝关节炎患者共98膝进行置换,术后屈曲受限有27膝,屈曲正常71膝。多因素分析结果显示,体质量指数、术前关节活动度、术后关节线高度变化均为影响人工全膝关节置换术后屈曲受限的相关因素,差异有统计学意义(χ^(2)=12.823、16.285、5.368,P<0.05)。结论:影响人工全膝关节置换术后屈曲受限的因素主要为:体质量指数、术前关节活动度、术后关节线高度变化,体质量指数越高、术前关节活动度越小、术后关节线高度变化越大,屈曲受限发生风险越高。

Objective:To investigate the influencing factors of flexion limitation after artificial total knee arthroplasty.Methods:A total of 86 patients with knee arthritis who underwent total knee arthroplasty in the hospital from February 2018 to June 2020 were selected as the research subjects.The patients were followed up for half a year after the operation,and the knee flexion was counted.They were divided into good flexion group(flexion range of motion≥90°)and restricted flexion group(flexion range of motion<90°).Univariate analysis and multivariate logistic regression analysis of flexion limitation after total knee arthroplasty were performed.Results:A total of 98 knees were replaced in 86 patients with knee arthritis,27 knees had limited flexion postoperatively,and 71 knees had normal flexion.The results of multivariate analysis showed that body mass index,preoperative range of motion,and postoperative changes in joint line height were all related factors affecting flexion limitation after total knee arthroplasty(χ^(2)=12.823,16.285,5.368,P<0.05).Conclusion:The main factors affecting flexion limitation after total knee arthroplasty are body mass index,preoperative joint range of motion,and postoperative joint line height changes.The greater the change in height,the higher the risk of flexion limitation.