TKA对晚期膝骨性关节炎临床疗效和下肢力线的影响

Effect of TKA on clinical efficacy and lower limb force line of late knee osteoarthritis

目的探讨全膝关节置换术(TKA)对晚期膝骨性关节炎临床疗效和下肢力线的影响,为患者的恢复提供临床指导。方法选择2019年6月-2021年6月收治的106例晚期膝骨性关节炎患者作为研究对象。所有患者均采取TKA治疗。并记录术前及术后6个月所有患者的膝关节功能情况,包括视觉模拟评分法(VAS)评分、美国特种外科医院(HSS)评分、膝关节屈曲度、膝关节活动度;下肢力线情况,包括髋膝踝角(A角)、膝关节外翻角(B角)、胫骨角(C角)、踝角(D角)及术后6个月治疗效果。结果术后6个月,所有患者治疗总有效率为94.3%,治疗效果显著;所有患者术后VAS评分平均为(1.1±0.7)分,明显低于术前的(5.7±2.1)分;术后HSS评分、膝关节屈曲度、膝关节活动度分别为(92.6±9.4)分、(17.6±1.3)°、(97.4±11.3)°,明显高/大于术前的(35.7±2.3)分、(1.3±0.2)°、(33.5±3.4)°,差异有统计学意义(P<0.05);所有患者术后A角平均为(178.1±4.2)°,明显大于术前的(172.9±3.1)°,术后B角、C角、D角分别为(5.4±0.8)°、(94.5±2.1)°、(90.5±2.8)°,明显小于术前的(7.0±1.2)°、(98.9±2.7)°、(98.6±3.1)°,差异有统计学意义(P<0.05)。结论全膝关节置换术治疗晚期膝骨性关节炎疗效显著,可有效改善患者膝关节功能,促进下肢力线恢复,具有临床应用价值,值得推广。

Objective To study the effect of total knee arthroplasty(TKA)on the clinical efficacy and lower limb force line of patients with advanced knee osteoarthritis,and to provide clinical guidance for the recovery of patients.Methods One hundred and six patients with advanced knee osteoarthritis admitted in our hospital from June 2019 to June 2021 were selected as the study subjects.All patients were treated with TKA.The knee joint function(VAS score,American Special Surgery Hospital(HSS)score,knee joint flexion,knee joint range of motion),lower limb force line(hip knee ankle angle(A angle),knee joint valgus angle(B angle),tibial angle(C angle),ankle angle(D angle))of all patients were recorded before and 6 months after the operation,and the treatment effect of all patients was recorded 6 months after the operation.Results Six months after operation,the total effective rate of all patients was 94.3%,and the therapeutic effect was significant;The mean postoperative VAS score of all patients was(1.1±0.7),which was significantly lower than that of preoperative patients(5.7±2.1).The postoperative HSS score,knee flexion and knee motion were(92.6±9.4),(17.6±1.3)°and(97.4±11.3)°,respectively,which were significantly higher/higher than that of preoperative patients(35.7±2.3),(1.3±0.2)°and(33.5±3.4)°(P<0.05);The average postoperative angle A of all patients was(178.1±4.2)°,significantly higher than the preoperative angle(172.9±3.1)°.Postoperative angle B,C and D were(5.4±0.8)°,(94.5±2.1)°and(90.5±2.8)°,respectively,significantly lower than the preoperative angle(7.0±1.2)°,(98.9±2.7)°and(98.6±3.1)°,with a statistically significant difference(P<0.05).Conclusion Total knee arthroplasty has a significant effect in the treatment of advanced knee osteoarthritis,which can effectively improve the knee joint function of patients and promote the recovery of lower limb force line.It has clinical application value and is worth promoting.