【摘要】 目的探讨僵硬膝关节(活动度小于50°)行人工全膝关节置换术的手术策略及疗效。方法对2005年4月～2009年1月间收治的30例僵硬膝关节患者(类风湿性关节炎16例,骨性关节炎11例,强直性脊柱炎2例,血友病性关节炎1例)进行回顾性研究,患者术前膝关节活动度平均为39.6°(10～50°),屈曲挛缩角度平均为32.3°(0～55°),膝关节HSS评分平均40.2分(15～71分)。结果 8例患者出现下肢肌间静脉或深静脉血栓;术中髌腱撕脱2例,采用钢丝固定。27例获得平均18个月随访,术后膝关节活动度平均为89°(50～120°),HSS评分平均为82分(70～95分)。结论术前活动度差的僵硬膝关节行人工全膝关节置换治疗,需要在手术入路、截骨技术、软组织松解、术后康复等多个环节精确设计,综合考虑上述措施才能获得满意的疗效。更多还原

【Abstract】 Objective To discuss the strategy and results of total knee arthroplasty for stiff knee.Methods A retrospective study was performed for 30 cases between 2005 and 2009.There were 16 cases of rheumatoid arthritis,11 cases of osteoarthritis,2 cases of ankylosing spondylitis and 1 case of hemophilic arthritis.The preoperative arc of movement was 39.6°(range,10~50°),flexion contracture was 32.3° (range,0~55°),HSS knee score was 40.2 (range,15~71).Results The difficulties encountered in surgical exposure were managed by using various extensile exposure techniques.The average postoperative ROM at 18 months follow-up was 89°(50~120°).HSS knee score was 82 (range,70~95).Conclusion Total knee arthroplasty in stiff knees can achieve correction of deformity with a significant gain in range of motion and marked improvement in quality of life.更多还原