老年患者全膝关节置换术后疗效分析

doi:10.16260/j.cnki.1009-2188.2018.02.015

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摘要　目的　分析老年患者全膝关节置换术(total knee arthoplasty, TKA)的术后疗效。　方法回顾性总结我科2008年10月～2017年10月完成的110例TKA病例资料，全部病例均测量术前及术后1周、术后6个月的HSS膝关节评分、膝关节活动度、大腿周径和小腿周径等。　结果　全部110例患者均顺利完成手术，未出现明显并发症。术后1周，膝关节活动度由术前86.54°±17.93°改善到术后107.20°±11.41°，HSS评分由术前(50.48±8.40)分改善到术后(90.60±3.61)分；2个时间点比较差异显著(P<0.05)；术后6个月，膝关节活动度及HSS稍有下降，但与术前比较仍有显著差异(P<0.05)，而与术后1周比较无明显差异(P>0.05)。术后1周患者的大、小腿周径有明显肿胀，但6个月后恢复，与术前比较无明显差异(P>0.05)。膝关节功能评分优95例，良5例，可10例，优良率90.1%。　结论膝关节置换的关键在术前对病例正确的选择，手术指针的把握，术中正确的截骨和软组织平衡。

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	汪更胜，朱新林，殷丹

关键词: 全膝关节置换术　膝关节炎　老年人

Abstract: Objective　To analyze the postoperative outcomes of total knee arthroplasty (TKA) in elderly patients.　Methods　A retrospective review of 110 TKA cases completed in our department from October 2008 to October 2017 were conducted.　Results　All 110 patients successfully completed the operation without obvious complications. One weeks after operation, the knee joint activity improved from 6.54°±17.93° to 107.20°±11.41°, and the HSS score improved from 50.48±8.40 to 90.60±3.61, which were significantly higher than the pre-operative ones (P<0.05). Although the knee joint activity and HSS decreased slightly after 6 months, but there were still higher than before the pre-operative ones (P<0.05). The knee function score was excellent in 95 cases, good in 5 cases, fair in 10 cases, and the excellent and good rate was 90.1%.　Conclusion　The key to TRA is correct selection of cases before operation, proper grasp of operative pointers, correct osteotomy and soft tissue balance during operation.

Key words: total knee arthroplasty 　knee arthritis 　aged

出版日期: 2018-04-26 发布日期: 2018-08-14 期的出版日期: 2018-04-26

ZTFLH:	R687.4
	R684.3

基金资助: 国家自然科学基金青年基金(编号：81300798)|湖南省自然基金(编号：2018JJ3737)|湖南省科技厅资助课题(2015TP2007)

通讯作者: 李芸

作者简介: 汪更胜，男，41岁，解放军第163医院湖南师范大学第二附属医院主治医师。

引用本文:

汪更胜，朱新林，殷丹. 老年患者全膝关节置换术后疗效分析[J]. 中国现代手术学杂志, 2018, 22(2): 142-144.
WANG Geng-sheng. Clinical Results of the Total Knee Arthoplasty in the Aged. Chinese Journal of Modern Operative Surgery, 2018, 22(2): 142-144.

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http://www.surgerychina.com/CN/10.16260/j.cnki.1009-2188.2018.02.015 或 http://www.surgerychina.com/CN/Y2018/V22/I2/142

[1]　Wang Z, Wei M, Zhang Q, et al. Comparison of high-flexion and conventional implants in total knee arthroplasty: a meta-analysis[J]. Med Sci Monit， 2015， 21:1679-1686. doi: 10.12659/MSM.893112.|[2]　周一新，邵宏翊，唐竟，等. 不同年龄患者人工膝关节置换术后疗效与围术期并发症分析[J]. 中国外科杂志，2009,47(11)：833-836.|[3]　张国宁, 王友. 膝关节评分标准的评估[J].中华外科杂志,2006，44(16)：1141-1143.|[4]　韩宁, 姚建华. 膝关节置换术功能评分方法优缺点对比[J]. 医学综述,2015,21(21):3919-3921.|[5]　Davies AP. Rating systems for total knee replacement[J]. Knee, 2002 ,9(4):261-266.|[6]　Lingard EA, Katz JN, Wright RJ, et al. Validity and responsiveness of the Knee Society Clinical Rating System in comparison with the SF-36 and WOMAC[J]. J Bone Joint Surg Am, 2001,83-A(12):1856-1864.|[7]　谭海涛, 陈铖，曾跃林，等. 全膝关节置换手术期应用氨甲环酸的研究与分析[J]. 中国骨与关节损伤杂志,2016,31(6):48-49.