McAuley James P, Harrer Michael F, Ammeen Deborah, Engh Gerard A
Anderson Orthopaedic Research Institute, Alexandria, VA 22307, USA.
Clin Orthop Relat Res. 2002 Nov(404):203-7. doi: 10.1097/00003086-200211000-00033.
In the current study, 27 consecutive total knee arthroplasties in 21 patients were assessed. All patients had a preoperative range of motion of less than 50 degrees, severe debilitation, and a minimum clinical and radiographic followup of 2 years (mean, 6 years; range, 2.3-11.8 years). The mean preoperative arc of motion was 30 degrees (range, 0 degrees -50 degrees) and improved to a mean 74 degrees (range, 15 degrees -110 degrees) postoperatively. Preoperative flexion contracture was corrected from a mean 28 degrees (range, 0 degrees -60 degrees) to a mean postoperative flexion contracture of 4.4 degrees (range, -5 degrees -30 degrees). In this series, the overall complication rate was 41% and the revision rate was 18.5%. The clinical significance of this study is that patients with stiff knees who are debilitated severely can have an improved quality of life after total knee arthroplasty, reflected by an increased walking tolerance, increased functional abilities, and decrease in pain, but in association with a high risk of complications and subsequent revisions.
在本研究中，对21例患者的27例连续全膝关节置换术进行了评估。所有患者术前活动范围均小于50度，衰弱严重，临床和影像学随访至少2年（平均6年；范围2.3 - 11.8年）。术前平均活动弧为30度（范围0度至50度），术后改善至平均74度（范围15度至110度）。术前屈曲挛缩从平均28度（范围0度至60度）矫正至术后平均屈曲挛缩4.4度（范围 - 5度至30度）。在该系列中，总体并发症发生率为41%，翻修率为18.5%。本研究的临床意义在于，严重衰弱的膝关节僵硬患者在全膝关节置换术后生活质量可得到改善，表现为步行耐力增加、功能能力增强和疼痛减轻，但伴有较高的并发症风险和随后的翻修风险。
