摘要
目的 比较不同K-L分级的膝骨关节炎(KOA)行全膝关节置换术(TKA)治疗的效果.方法 将108例行TKA治疗的KOA患者根据术前K-L分级不同分为K-L2级组(29例)、K-L 3级组(47例)和K-L 4级组(32例).记录开始下地时间、开始部分负重行走时间、开始完全负重行走时间、膝关节屈曲活动度.采用HSS评分评价膝关节功能,采用IKDC膝关节功能主观评分评价膝关节功能,采用Mar-shall评分评价韧带恢复效果.结果 患者均获得6个月随访.开始下地时间、开始部分负重行走时间、开始完全负重行走时间:K-L2级组均短于K-L3级组、K-L4级组(P＜0.05);K-L3级组均短于K-L 4级组(P＜0.05).术后6个月HSS评分、IKDC评分、Mar-shall评分、膝关节屈曲活动度:K-L2级组均高(大)于K-L3级组、K-L4级组(P＜0.05);K-L3级组均高(大)于K-L4级组(P＜0.05).末次随访时,患者均行走自如,膝关节无疼痛,X线片显示假体位置良好,无松动及脱位情况发生.结论 TKA治疗KOA能有效改善患者膝关节功能,但术前K-L分级越高,手术效果越差.
Abstract
Objective To compare the effects of total knee arthroplasty(TKA)for knee osteoarthritis(KO A)with dif-ferent K-L grades.Methods The 108 patients with KOA who underwent TKA were divided into three groups accord-ing to different K-L grades:K-L grade-2 group(29 cases),K-L grade-3 group(47 cases),and K-L grade-4 group(32 cases).The time of starting to stand,start to walk time with partial weight-bearing,time to walk with full weight-bear-ing,and knee flexion ROM were recorded.The knee function was evaluated with HSS score,the subjective knee func-tion was evaluated by using the IKDC score,and the recovery effect of the ligaments was assessed with Mar-shall score.Results All patients were followed up for 6 months.The time to first weight-bearing,start to walk time with partial weight-bearing,and time to walk with full weight-bearing:the data of K-L grade-2 group were all shorter than those in K-L grade-3 group and K-L grade-4 group(P＜0.05),while K-L grade-3 group was shorter than K-L grade-4 group(P＜0.05).HSS scores,IKDC scores,Mar-shall scores,knee flexion ROM:K-L grade-2 group was all bigger(larger)than those in K-L grade-3 group and K-L grade-4 group(P＜0.05),while K-L grade-3 group was bigger(larger)than K-L grade-4 group(P＜0.05).At the last follow-up,all patients walked freely,without knee pain,and X-ray showed good prosthesis position,without loosening or dislocation.Conclusions TKA treatment for KOA can ef-fectively improve knee joint function in patients,but preoperative K-L grade is higher,the surgical outcome is worse.
维普
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