Emerson R H, Ayers C, Higgins L L
Texas Center for Joint Replacement, Presbyterian Hospital of Plano, TX 75093, USA.
Clin Orthop Relat Res. 1999 Nov(368):176-81.
The benefits of closing the surgical wound of a primary and revision total knee prosthesis with the knee in full flexion are examined. A previous study showed that surgically closing the primary knee arthroplasty with the knee in full flexion produced significantly more postoperative flexion at 6 months: 114.7 degrees compared with 108.1 degrees. Of 108 selected sequential primary knee arthroplasties, the first 52 knees were closed surgically with the leg in full knee extension, and the second 56 knees were closed in 90 degrees to 110 degrees flexion, depending on the available motion of the joint. The patients in each group were matched closely in age, weight, height, gender, and surgical technique. At all followup intervals, the flexion measurements were significantly better in the flexion closure group. At 1 year, the flexion group had 117.9 degrees and the extension group had 112.9 degrees flexion. The revision series also was a selected sequential series with 13 knees in each closure group. In the revision case, the 1-year findings were similar, with significantly more knee flexion in the flexion closure group (118.7 degrees compared with 112.7 degrees). In matched groups, flexion closure in primary and revision knee replacements significantly increased total range of motion, as seen at the 1-year followup.
研究了在膝关节完全屈曲状态下闭合初次和翻修全膝关节假体手术切口的益处。先前的一项研究表明，在膝关节完全屈曲状态下手术闭合初次膝关节置换术的切口，术后6个月时的屈曲角度明显更大：分别为114.7度和108.1度。在108例连续入选的初次膝关节置换术中，前52例膝关节在膝关节完全伸直状态下进行手术闭合，后56例膝关节根据关节的活动度在90度至110度屈曲状态下进行闭合。每组患者在年龄、体重、身高、性别和手术技术方面进行了密切匹配。在所有随访期间，屈曲闭合组的屈曲测量结果明显更好。1年时，屈曲组的屈曲角度为117.9度，伸直组为112.9度。翻修系列也是一个连续入选的系列，每个闭合组有13例膝关节。在翻修病例中，1年的结果相似，屈曲闭合组的膝关节屈曲明显更多（分别为118.7度和112.7度）。在匹配组中，初次和翻修膝关节置换术中的屈曲闭合显著增加了总活动范围，如1年随访时所见。
