人工全膝关节置换术中保留滑膜对术后膝关节功能的影响

Effect of synovial membrane retention on knee joint function after total knee arthroplasty

目的研究膝骨性关节炎患者行人工全膝关节置换术时进行滑膜切除与否对术后膝关节功能恢复的影响。方法选择河南省洛阳正骨医院2014年—2017年79例符合原发性膝骨关节炎诊断标准的患者,年龄48～82岁,试验组:41例关节置换术中保留滑膜;对照组:38例关节置换行滑膜切除。随访0～12个月。分别对术前和术后1 d、3 d,4周和12个月膝关节术后临床效果。采用VAS评分和KSS评分评价手术效果。结果进行统计学分析,在两组患者KSS临床评分及功能评分对比术后4周及术后12个月差异无统计学意义。在两组患者对比术后4周VAS疼痛评分及术后12月差异无统计学意义(P>0.05)。结论行TKA治疗OA时,术中行滑膜切除与保留滑膜相比,对膝关节功能恢复无影响。

Objective To study the effect of synovectomy on knee joint function recovery in patients with knee osteoarthritis(OA)undergoing total knee arthroplasty(TKA).Methods From 2014 to 2017 totally 79 patients who met the diagnostic criteria for primary knee osteoarthritis,aged 48-82 years,the experimental group 41 patients retained synovium during joint replacement,and the control group 38 joint replacements synovectomy.Followed up for 0 to 12 months.The clinical effects of knee joint surgery before and 1 day,3 days,4 weeks and 12 months after surgery were performed.Surgical outcomes were assessed using VAS scores and KSS scores.Results According to statistical analysis,there was no significant difference in the clinical scores and functional scores between the two groups at 4 weeks after surgery and 12 months after surgery.There was no significant difference in VAS pain scores between the two groups at 4 weeks postoperatively and 12 months after surgery(P>0.05).Conclusion When TKA was used to treat OA,intraoperative synovectomy had no effect on knee function recovery compared with retention of synovium.