冯会成1 黄迅悟1 毕龙2 孙继桐1 常青1.严重骨质疏松患者全膝关节置换术疗效分析[J].,2011,11(3):538-540 |
严重骨质疏松患者全膝关节置换术疗效分析 |
Total Knee Replacement for Patients with Severe Osteoporosis |
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DOI: |
中文关键词: 骨质疏松 全膝关节置换 骨密度 关节功能 |
英文关键词: Osteoporosis Total knee replacement Bone mineral density Joint function |
基金项目:国家自然科学基金(30901532) |
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中文摘要: |
目的:探讨严重骨质疏松患者在进行人工全膝关节置换术时的特点和围手术期处理方法。方法:2005年至2007年期间,我
科进行伴有严重骨质疏松症的人工全膝关节置换术患者共计36 例41 膝,其中单膝关节置换31 例,双膝置换5 例。所有病例入
院前均采用双光能X线骨密度仪(DEXA)检测骨密度。所有病例均采用后稳定型膝关节假体。患者在术前给予钙尔奇D片及鲑鱼
降钙素等抗骨质疏松治疗1月,术后继续给予抗骨质疏松治疗2~3月。结果:术后切口均一期愈合,无并发症。所有病例随访时间
36~60个月,平均49 个月。膝关节功能评分(HSS评分法)术前平均为37.2±6.4 分,术后平均评分94.6±8.8 分,随访期间未见假
体早期松动影像学改变,骨密度复查较术前有明显改善。结论:对于伴有严重骨质疏松的病例,骨质已受到不同程度的破坏,进行
假体选择的个体化,手术操作的精细化以及术后康复治疗具体化等对临床疗效至关重要。 |
英文摘要: |
Objective: To discuss the treating effects and perioperative curing methods of total knee replacement on serious osteoporosis
patients. Methods: From 2005 to 2007 we treated 36 osteoarthritis patients by total knee joint replacement. The bone mineral density
(BMD) of all these patients was measured by dual energy X-ray absorptiometry (DEXA). All the patients were treated by legacyposterior
stabilization Flex knee arthroplasty (LPS-FKA). Anti-osteoporosis drugs were used one month before and two to three months later
of the operation. Results: The results of short term follow-up showed that all the cuts were A healing and all the fixation were stable, the
compression symptoms were relieve or vanish. The function of the knee joint was measured by HSS score. Pre-operation the average
score of the patients was 37.2±6.4, and post-operation the score was raised to 94.6±8.8. The BMD of all the patients was also improved.
Conclusions: Due to the poor stability of the damaged bone quality, the individual prosthesis, careful operation and specific rehabilitation
should be emphasized, when serious osteoporosis patients were treated. |
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