目的 探讨采用初次全膝关节置换术治疗壤塘地区膝关节大骨节病(KBD)患者的近期临床效果。方法 回顾性分析2017-01至2019-09四川省壤塘县人民医院骨科收治膝关节大骨节病患者88例,男32例,女56例,年龄34~67岁,平均(53.57±10.40)岁。Ⅰ期35例,Ⅱ期53例。全部膝关节大骨节病患者行人工全膝关节置换术,分别在术前,术后1、3、6、12、36个月,采用疼痛视觉模拟评分(VAS)评估膝关节疼痛严重程度、美国膝关节协会评分(KSS评分)、美国特种外科医院膝关节评分(HSS评分)系统评估膝关节功能,简明健康状况量表(SF-36)评分评估生活质量,测量膝关节活动度(ROM),治疗前和末次随访时拍摄双下肢负重全长 X光片测量髋-膝-踝角及胫股角评估下肢力线情况。结果 随访36～54个月,平均随访(39.85±6.89)个月。VAS疼痛评分、HSS临床评分、KSS功能评分、SF-36评分、生理职能、躯体疼痛、活力、社会功能、情感职能、精神健康评分得到明显改善(P<0.05)。下肢力线髋膝踝角(HKA)、ROM得到改善(P<0.05)。结论 高原地区膝关节大骨节病Ⅰ期、Ⅱ期患者行首次接受人工关节置换术后能矫正下肢力线,缓解膝关节疼痛,改善关节功能,值得临床推广。
Abstract
Objective To investigate the short-term clinical effect of total knee arthroplasty in the treatment of Kashin-Beck disease (KBD) of the knee in Ramtang area.Methods A retrospective analysis was performed on 88 patients with KBD (32 males and 56 females) aged from 34 to 67 years, with an average age of (53.57±10.40) years, who were admitted to the Department of Orthopedics of Rangtang County People’s Hospital of Sichuan Province from January 2017 to September 2019. There were 35 cases of stage I and 53 cases of stage II. All the patients with KBD were treated with total knee arthroplasty for the first time. Before operation and at 1, 3, 6, 12 and 36 months after the operation, the pain severity of the knee joint were evaluated by visual analogue scale (VAS) and the knee society knee score (KSS). The hospital for special surgery knee score (HSS score) systematically evaluated the knee function, the SF-36 score evaluated the quality of life, and the ROM of the knee joint was measured. Before treatment and at the last follow-up, the full-length X-ray films of both lower limbs were taken to measure the hip knee ankle angle and tibiofemoral angle to assess the lower limb force line.Results The patients were followed up for 36 to 54 months, with an average of (39.85±6.89) months. VAS pain score, HSS clinical score, KSS function score, SF-36 score, physiological function, physical pain, vitality, social function, emotional function, and mental health score were improved. The lower limb force line hip knee ankle angle (HKA) and ROM were improved (P<0.05).Conclusions The patients with KBD in stage Ⅰ and stage Ⅱ at high altitude can correct the lower limb force line, relieve the knee joint pain and improve the joint function after the first artificial joint replacement, which is worthy of clinical promotion.
关键词
高原地区 /
全膝关节置换术 /
大骨节病
Key words
plateau area /
total knee arthroplasty /
Kaschin-Beck disease
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参考文献
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基金
军队医学科技青年培育计划孵化项目(21QNPY117)
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