Kim Y H, Kim J S, Cho S H
The Joint Replacement Center of Korea affiliated with Ahn Sei Hospital, Seoul.
J Arthroplasty. 2000 Jun;15(4):453-60. doi: 10.1054/arth.2000.4640.
This study compares the results of 16 total knee arthroplasties after a spontaneous osseous ankylosis and 14 total knee arthroplasties after a takedown of formal knee fusion. This series is a collection of patients who have either ankylosis or arthrodesis because of previous pyogenic or tuberculous infection. There were 18 women and 12 men. The age at operation ranged from 30 to 62 years (average, 42.9 years). The duration of ankylosis was longer in the patients in the spontaneous ankylosis group (19.7 years) than in the patients in the formally fused knee group (11.3 years). The duration from prior infection to arthroplasty was 12.4 years (range, 6-22 years) in the patients in the formally fused group and 20.4 years (range, 7-39 years) in the patients in the spontaneous ankylosis group. The original diagnosis was tuberculous arthritis in 14 knees and pyogenic arthritis in 16 knees. The average follow-up was 5.3 years (range, 5-6 years). Gender, age, diagnosis, and follow-up period were comparable in both groups. The preoperative Hospital for Special Surgery Knee Score was 60 in both groups, and the average knee score in both groups at the final follow-up was 73 (range, 67-75). Comparison of the patient's preoperative and postoperative ambulatory status revealed functional improvement in both groups. The average range of active flexion in both groups was 75.8 degrees (range, 70 degrees-95 degrees). The extension lag in both groups averaged 9 degrees (range, 0 degrees-20 degrees). The range of motion was approximately the same in both groups. The angular deformity was corrected to 0 degrees to 10 degrees of valgus angulation in all knees. There was no revised prosthesis for loosening at the final follow-up. Complications included skin edge necrosis (53.3%), pyogenic infection in 2 patients, and a quadriceps tendon rupture in 1 patient.
本研究比较了16例自发骨性强直后全膝关节置换术的结果与14例膝关节融合松解术后全膝关节置换术的结果。该系列病例收集了因既往化脓性或结核性感染导致关节强直或关节融合的患者。其中女性18例，男性12例。手术年龄在30至62岁之间（平均42.9岁）。自发强直组患者的强直持续时间（19.7年）长于膝关节融合组患者（11.3年）。融合组患者从既往感染到关节置换的时间为12.4年（范围6 - 22年），自发强直组患者为20.4年（范围7 - 39年）。最初诊断为结核性关节炎的有14例膝关节，化脓性关节炎的有16例膝关节。平均随访时间为5.3年（范围5 - 6年）。两组在性别、年龄、诊断和随访时间方面具有可比性。两组术前特种外科医院膝关节评分均为60分，末次随访时两组膝关节平均评分均为73分（范围67 - 75分）。比较患者术前和术后的步行状态，发现两组功能均有改善。两组主动屈曲平均范围为75.8度（范围70度 - 95度）。两组伸直滞后平均为9度（范围0度 - 20度）。两组活动范围大致相同。所有膝关节的角畸形均矫正至外翻角0度至10度。末次随访时无因假体松动而翻修的情况。并发症包括皮肤边缘坏死（53.3%），2例化脓性感染，1例股四头肌肌腱断裂。
