全膝关节表面置换术治疗骨关节病及类风湿性关节炎的疗效——109例随访疗效分析Curative Effect of Rheumatism and Osteoarthritis Treated with Total Knee Replacement——with Analysis of 109 Cases
章波,娄思权,张克,刘岩,藏磊
摘要(Abstract):
目的 :报告 10 9例全膝关节表面置换术治疗骨关节病及类风湿性关节炎的疗效。方法 :对 10 9例全膝关节置换术的患者进行随访 ,并用HSS评分系统进行分析 ;随访 11~ 84个月 ,平均 3 4.2个月。结果 :手术优良率 89%。病人术后在疼痛、功能方面都有明显改善 ,尤其在缓解疼痛方面效果显著。但在关节活动度方面改善不明显。结论 :全膝关节表面置换术对治疗严重骨关节病及类风湿性关节炎效果满意 ,为了能够取得更好的疗效应该注重术中髌骨轨迹的纠正及病人的术前教育及术后康复指导。
关键词(KeyWords): 膝关节;全膝关节置换术;风湿病;骨关节炎
基金项目(Foundation):
作者(Author): 章波,娄思权,张克,刘岩,藏磊
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