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旋转平台膝关节假体置入治疗膝关节病62例 预览

Treatment of knee arthropathy with rotating-platform knee prosthesis in 62 cases
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摘要 目的:观察采用旋转平台膝关节假体行人工膝关节置换治疗膝关节疾病的疗效。方法:回顾性分析2005-01/2009-01山东大学附属省立医院收治的行人工膝关节置换患者62例(74膝),男36例(41膝),女26例(33膝);年龄52-79岁,平均61.5岁;左侧28例,右侧22例,双侧12例。其中骨性关节炎34例,类风湿性关节炎21例,创伤性关节炎7例。所有患者均选用旋转平台膝关节假体进行置换,且为首次置换,未置换髌骨。采用HSS膝关节评分标准对置换前后膝关节功能进行评估。结果:62例(74膝)患者均进行了随访,时间3-48个月,平均22个月。病例刀口均一期愈合,未出现感染和明显关节血肿。2例术后3d出现下肢肿胀,经超声多普勒检查确诊轻度下肢深静脉血栓形成,给予低分子肝素钠和拜阿司匹林等药物治疗,10d后肿胀消退。62例患者术后疼痛解除,功能明显改善。置换前HSS评分为34-58分,平均44.99分;置换后69-98分,平均88.78分,其中优45例(55膝),良16例(18膝),可1例,优良率98%。X射线平片未发现存在假体周围的X射线透亮区,亦未发现假体脱位征象。结论:选用旋转平台膝关节假体行人工膝关节置换治疗膝关节病手术简便,术后恢复好,并发症少,短期临床效果满意。 OBJECTIVE: To study the therapeutic effect of treating knee arthropathy with total knee arthroplasty using rotating-platform knee prosthesis. METHODS: A total of 62 patients (74 knees) in Provincial Hospital Affiliated To Shandong University from January 2005 to January 2009 were selected, including 36 males (41 knees) and 26 females (33 knees), aged 52-79 years, mean aged 61.5 years; 28 cases with left knee, 22 cases with right knee and 12 cases of both knees. The cases were composed of 34 cases with osteoarthritis, 21 cases with rheumatoid arthritis and 7 cases with traumatic arthritis. All the patients received the total knee arthroplasty for the first time using rotating-platform knee prosthesis, no replacement of the patella. The clinical results of pre-operation and after-operation were evaluated by the HSS knee rating score system. RESULTS: All the patients were followed-up for averaged 22 months (3-48 months) after operation. Incisions of all the cases were healed, and there was no infection and hematoma. Lower extremity deep venous thrombosis occurred in 2 cases at 3 days after operation. Swelling disappeared through drug treatment 10 days later. Pain and function of all the patients were obviously ameliorated after operation. The average HSS knee rating score was 44.99 (from 34 to 58) before total knee arthroplasty, which was improved to 88.78 (from 69 to 98), and the good-to-excellent rate was 98% (excellent 45 cases, good 16 cases, average 1 case). There were no signs of prosthetic dislocation or loosening in the X-ray films. CONCLUSION: Total knee arthroplasty using rotating-platform knee prosthesis owns advantages of easy surgical operation, less complications, good recovery and satisfactory results in a short-term.
作者 李斌 张伟 孙水 曲华正 孙西涛 Li Bin, Zhang Wei, Sun Shui, Qu Hua-zheng, Sun Xi-tao(Department of Joint Surgery, Provincial Hospital Affiliated to Shandong University, Ji'nan 250021, Shandong Province, China)
出处 《中国组织工程研究与临床康复》 CAS CSCD 北大核心 2009年第48期 9575-9578,共4页 Journal of Clinical Rehabilitative Tissue Engineering Research
作者简介 李斌,男,1979年生,山东省平度市人,汉族,山东大学在读硕士,主治医师,主要从事骨关节外科的研究。libinl19966@sohu.com 通讯作者:张伟,硕士生导师,教授,主任医师,山东大学附属省立医院关节外科,山东省济南市250021
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