| 白国玺 徐小会 段永宏 郭 凯 王华溢 朱锦宇 朱庆生.全膝关节置换术治疗晚期类风湿性关节炎的早期临床随访研究[J].,2014,14(35):6926-6930 |
| 全膝关节置换术治疗晚期类风湿性关节炎的早期临床随访研究 |
| The Short-term Clinical Outcome of Total Knee Arthroplasty in theTreatment of Patients with Rheumatoid Arthritis |
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| DOI： |
| 中文关键词: 晚期类风湿性关节炎 全膝关节置换术 髌骨置换 治疗效果 安全性 |
| 英文关键词: Advance rheumatoid arthritis Total knee arthroplasty Patellar resurfacing Efficacy Safety |
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| 中文摘要: |
| 目的： 探讨全膝关节置换术(TKA)治疗晚期类风湿性膝关节炎(RA)的早期临床疗效和安全性。 方法： 回顾性分析 2006 年～
2011 年接受 TKA 治疗的 69 例 (102 膝)晚期膝关节 RA 患者的临床资料， 术后及随访时分析患者的影像学资料， 末次随访时进行
膝关节 HSS 评分， 采用 英国矫形外科协会标准评定患者满意度， SF-36 健康量表评定患者的生活质量。 结果： 54 例 (81 膝)患者术
后获得 2～ 7 年(平均 4.3 年)随访； 6 例 (7 膝)死亡， 6 例 (10 膝)失访， 3 例 (4 膝)翻修， 获得随访患者中 1 例 (1 膝)发生下肢深静脉血
栓， 经介入放置滤网 治疗 康复后出 院， 1 例（ 1 膝）感染。 末次随访时， 膝关节活动度(ROM)从术前平均 (71 .03° ± 29.51° )提高至
(92.26° ± 10.29° )， 膝关节 HSS 评分从术前平均 (47.30± 10.06)分提高至(75.93± 9.17)分； 疼痛 发生率和疼痛 评分均较术前显著
降低； 冠状面和矢状面畸形率均较术前显著降低； 身体健康(PCS)平均 (47.98± 6.96)分， 心理健康(MCS)平均 (41.45± 5.67)分， 均较
术前显著增加， 差异均有统计学意义(P<0.05)。 患者的治疗 满意率为 96.30%， 膝关节假体 X 线片 采用 膝关节学会的 X 线评价与计
分系统评价未见假体松动。 结论： TKA 治疗晚期膝关节 RA 患者 2～ 7 年的临床及影像学效果良好，未发现骨溶解、假体松动及严
重衬垫磨损等并发症。 |
| 英文摘要: |
| Objective:To investigate the short-term clinical efficacy and safety of total knee arthroplasty(TKA) in the treatment of
patients with rheumatoid arthritis(RA).Methods:The clinical data of 69 patients (1 02 knees) with RA who underwent TKA from 2006 to
201 1 were retrospectively studied. The postoperative X-ray imaging data were analyzed and the clinical efficacy was assessed at the last
follow-up by HSS system, the British Orthopaedic Association patient-satisfaction score and Short Form 36-item Survey (SF-36) were
respectively used to evaluate the patients’ satisfaction and quality of life. for patients’ health statuses.Results:54 patients (81 knees)
obtained an average follow-up of 4.3 years (from 2 to 7 years). 6 patients (7 knees) died, 6 patients (1 0 knees) were lost up, and 3 patient
(4 knee) underwent revision surgery. 1 patient (1 knee) had deep venous thrombosis and cured after intervention therapy. At the last
follow-up visit, the ROM increased from 71 .03° ± 29.51° (preoperation) to 92.26° ± 10.29° , the HSS of knee joint increased from
(47.30 ± 10.06) to (75.93 ± 9.1 7), the incidence rate of pain, pain score, aberration rate of coronal plane and vertical plane were
significantly lower than those preoperation. The PCS was (47.98± 6.96), MCS was 41 .45± 5.67, which were both predominantly higher
than those preoperation(P<0.05). The satisfaction rate of patients was 96.30%. No prosthetic loosening was found according to The Knee
Society total knee arthroplasty roentgen graphic evaluation and scoring system.Conclusion:The study showed good 2-7-year clinical and
radiological efficacy of TKA in the treatment of patients with RA. No serious complications such as osteolysis, loosening and severe
friction was found during the treatment. |
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