【摘要】 目的　探讨提高人工关节置换治疗膝关节骨性关节炎、类风湿性关节炎及其他病损引起的疼痛、功能障碍的疗效及早期并发症的预防。方法　自 1 998年至 2 0 0 3年 5月行膝关节置换 1 72例 ,1 96膝。用改良的膝关节股内侧肌切口 ,根据患者情况采用髌骨置换及滑膜切除。根据后交叉韧带情况选用非限制性 (CR)假体或部分限制性假体 (PS) ,个别病人因膝关节稳定机制的严重破坏而采用高限制性假体。结果　 1 72例 1 96膝经手术治疗优良率 94 3 % ,HSS评分由术前 40分提高到 83 6分 ,2例因迟发性感染经翻修术后治愈 ,1例因肺栓塞死亡。结论　人工膝关节置换术疗效满意 ,手术要求不影响关节稳定性情况下充分松解 ,根据病人情况选择合适的截骨角度及假体更多还原

【Abstract】 Objective To observe the outcomes of treatment and early complications in TKA in the treatment of OA, RA and the other diseases.Methods The clinical results of 172 patients (196 knees) were reviewed from 1998 to June 2003. A modified medialis approach of vastus medialis was use to expose the knee joint, the resection of stratum synoviale and the replacement of patella were performed according to lesions individually. The cruciate retained (CR) knee prosthesis or posterior stabilized (PS) knee prosthesis was selected in terms of the status of PCL. Occasionally, the hinged prosthesis was used in the patient with seriously destroyed knee.Result The rate of good to excellent clinical results was 94.3% in 172 cases of 196 knees. The HSS knee rating score improved from 40 to 83.6. Two cases were reoperated because of lately infection after knee arthroplasty. One was died of pulmonary embolism.Conclusion The early operative outcomes of TKA were satisfied. The following factors are beneficial to the operative outcome, the factors involve well release of soft tissue around the knee that will not cause knee instability, choosing the proper angle of osteotomy and prosthesis individually.更多还原