全膝关节置换术治疗老年膝骨关节炎的临床疗效

Clinical efficacy of total knee arthroplasty in the treatment of knee osteoarthritis in the elderly

目的 探讨全膝关节置换术(TKA)治疗老年膝骨关节炎的临床疗效。方法 采用TKA治疗67例老年膝骨关节炎患者。比较手术前后疼痛VAS评分、HSS评分、膝关节屈曲活动度(ROM)、WOMAC评分以及术后并发症发生情况,根据HSS评分标准评价疗效。结果 患者均获得随访,时间20~36个月。术后切口均无感染及延迟愈合;3例出现下肢肌间静脉血栓,溶栓后均治愈。随访期间均未出现关节感染及假体松动、移位、下沉迹象。末次随访时,疼痛VAS评分、WOMAC评分、HSS评分及膝关节屈曲ROM均较术前明显改善(P<0.05);根据HSS评分标准评价疗效:优42例,良20例,可5例,优良率92.5%。结论 TKA治疗老年膝骨关节炎可以减轻膝关节疼痛,改善膝关节功能,提高患者的生活质量。

Objective To investigate the clinical efficacy of total knee arthroplasty(TKA)in the treatment of knee osteoarthritis in the elderly.Methods The 67 elderly patients with knee osteoarthritis were treated with TKA.The pain VAS,HSS score,knee flexion range of motion(ROM)and WOMAC score,postoperative complication incidence conditions were compared before and after operation,and the curative effect was evaluated according to HSS scoring standard.Results All patients were followed up for 20~36 months.There was no infection and delayed healing of the incision after operation.There were 3 cases of lower extremity intermuscular venous thrombosis,which were cured after thrombolysis.During the follow-up period,there were no signs of joint infection,prosthesis loosening,displacement and subsidence.At the last follow-up,the pain VAS and WOMAC score,HSS score and knee flexion ROM were improved than those before the operation(P<0.05).The curative effect was assessed with HSS scoring standard,of which 42 cases were excellent,20 cases were good,5 fair,and the excellent-good rate was 92.5%.Conclusions TKA can improve the knee function,reduce knee pain and improve the quality of life of elderly patients with knee osteoarthritis.