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无菌性和感染性翻修全膝关节置换术的临床结果及患者满意度

Clinical outcome and patient satisfaction in aseptic and septic revision total knee arthroplasty.

作者信息

Wang Ching-Jen, Hsieh Ming-Chun, Huang Ting-Wen, Wang Jun-Wen, Chen Han-Shiang, Liu Chen-Yeo

机构信息

Department of Orthopedic Surgery, Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung, Taiwan.

出版信息

Knee. 2004 Feb;11(1):45-9. doi: 10.1016/S0968-0160(02)00094-7.

Abstract

This study compares clinical outcome and patient satisfaction in 33 aseptic and 15 septic revision total knee arthroplasties across a 30-130-month follow-up. Aseptic revisions included only knees in which the femoral, tibial and patellar components had been exchanged, and excluded knees in which only isolated patellar components had been revised or only the tibial insert exchanged. Septic revisions included only knees in which there had been successful revision for chronic infection without recurrence of infection for at least 2 years from the index revision. The evaluation included pain scores, knee scores, functional scores, SF-12 functional surveys and radiographs of the knee. The results for the aseptic group were excellent in 26 (78.8%), good in 3 (9.0%), fair in 2 (6.1%) and poor in 2 (6.1%); those for the septic group were excellent in 5 (33.3%), good in 7 (46.7%), fair in 2 (13.3%) and poor in 1 (6.7%). The overall results of septic revision were less satisfactory than for aseptic revision. Aseptic revisions achieved significantly better knee scores and ranges of motion than septic revisions, but their pain and functional scores were similar. Despite the difference in knee scores, 85% of the patients from both groups were equally satisfied with the results of treatment. There was no discernible radiographic difference between the two groups, including radiolucency.

摘要

本研究比较了33例无菌性和15例感染性全膝关节置换翻修术患者在30 - 130个月随访期内的临床结局和患者满意度。无菌性翻修仅包括股骨、胫骨和髌骨组件均已更换的膝关节,排除仅单独翻修髌骨组件或仅更换胫骨衬垫的膝关节。感染性翻修仅包括对慢性感染进行成功翻修且自初次翻修后至少2年无感染复发的膝关节。评估包括疼痛评分、膝关节评分、功能评分、SF - 12功能调查以及膝关节X线片。无菌性组的结果为优26例(78.8%)、良3例(9.0%)、中2例(6.1%)、差2例(6.1%);感染性组的结果为优5例(33.3%)、良7例(46.7%)、中2例(13.3%)、差1例(6.7%)。感染性翻修的总体结果不如无菌性翻修。无菌性翻修的膝关节评分和活动范围明显优于感染性翻修,但疼痛和功能评分相似。尽管膝关节评分存在差异,但两组中85%的患者对治疗结果同样满意。两组之间在影像学上没有明显差异,包括透亮线。

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