分期全膝关节置换术治疗高龄双膝关节骨关节炎的疗效
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摘要
目的探讨分期全膝关节置换术(TKA)治疗高龄双膝关节骨关节炎的临床疗效。方法 94例高龄双膝关节骨关节炎患者根据治疗方式分为分期组和同期组各47例,同期组患者行同期TKA,分期组患者行分期TKA,比较两组的康复效果以及术后并发症发生情况。结果术后6个月,两组患者的HSS膝关节评分和关节活动度均显著增加, WOMAC骨关节炎指数显著降低,组间差异无统计学意义(P>0.05)。分期组患者的切口延迟不愈合率显著低于同期组(P <0.05);两组患者的切口脂肪液化坏死率、深静脉血栓率和假体周围感染率比较,差异无统计学意义(P>0.05);分期组患者的并发症总发生率显著低于同期组(P<0.05)。结论分期TKA治疗高龄双膝关节骨关节炎的疗效与同期TKA相近,但分期TKA的术后并发症发生率更低。
Objective To investigate the clinical efficacy of staged TKA in the treatment of elderly double knee osteoarthritis.Methods A total of 94 cases of elderly patients with double knee osteoarthritis were divided into the staged group(staged TKA, n = 47) and the simultaneous group(simultaneous TKA, n = 47) according to the treatment methods. The rehabilitation effects and incidences of postoperative complications of two groups were compared. Results Six months after surgery, both groups had significantly increased HSS knee score and joint mobility, and significantly decreased WOMAC osteoarthritis index; No significant difference was found between the two groups(P >0.05).The rate of incision delayed non-healing of the staged group was significantly lower than that of the simultaneous group(P <0.05); No statistical difference was found between the two groups in the rates of incisional fat liquefaction necrosis, deep vein thrombosis and prosthetic infection(P >0.05); The total incidence of complications of the staged group was significantly lower than that of the simultaneous group(P <0.05).Conclusions Staged TKA has similar efficacy with simultaneous TKA in the treatment of elderly double knee osteoarthritis, but staged TKA has lower incidence of postoperative complications.
Objective To investigate the clinical efficacy of staged TKA in the treatment of elderly double knee osteoarthritis.Methods A total of 94 cases of elderly patients with double knee osteoarthritis were divided into the staged group(staged TKA, n = 47) and the simultaneous group(simultaneous TKA, n = 47) according to the treatment methods. The rehabilitation effects and incidences of postoperative complications of two groups were compared. Results Six months after surgery, both groups had significantly increased HSS knee score and joint mobility, and significantly decreased WOMAC osteoarthritis index; No significant difference was found between the two groups(P >0.05).The rate of incision delayed non-healing of the staged group was significantly lower than that of the simultaneous group(P <0.05); No statistical difference was found between the two groups in the rates of incisional fat liquefaction necrosis, deep vein thrombosis and prosthetic infection(P >0.05); The total incidence of complications of the staged group was significantly lower than that of the simultaneous group(P <0.05).Conclusions Staged TKA has similar efficacy with simultaneous TKA in the treatment of elderly double knee osteoarthritis, but staged TKA has lower incidence of postoperative complications.
引文
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[2]王波,胡海涛,潘健,等.膝关节骨性关节炎全膝关节置换术后下肢力线与早期临床效果关系的研究[J].中国骨与关节损伤杂志,2015, 30(10):1044-1048.
[3]潘风雨,罗毅.同期和分期全膝关节置换术治疗老年双膝关节骨关节炎的治疗效果[J].实用老年医学, 2016, 30(4):291-294.
[4]王昕,胡龙,王雄,等.同期或分期全膝关节置换术治疗高龄双膝关节骨关节炎的疗效[J].中国老年学杂志, 2017, 37(5):1201-1203.
[5]朱斌杰,陈哲峰,刘锋,等.同期和分期全膝关节置换术治疗双膝关节骨关节炎的安全性与疗效[J].中华骨科杂志, 2014, 34(6):619-623.
[6]鲁木,史然利,汪俊平,等.同期双侧与分期双侧关节置换治疗膝骨关节炎的对照研究[J].南通大学学报(医学版), 2015, 35(2):95-98.
[7]戚爱清,宋长志,纪标.同期和分期双侧全膝关节置换术治疗双膝骨性关节炎的疗效和安全性研究[J].临床和实验医学杂志, 2016,15(3):250-253.