Innocenti M, Civinini R, Carulli C, Villano M, Linari S, Morfini M
Second Orthopaedic Clinic, University of Florence; C.T.O. Largo Palagi 1, 50139, Florence, Italy.
Knee. 2007 Aug;14(4):264-8. doi: 10.1016/j.knee.2007.05.001. Epub 2007 Jun 29.
The results of 24 modular Genesis II (Smith & Nephew, Memphis, TN, USA) total knee arthroplasties, performed in 20 patients with haemophilia were prospectively reviewed. The hypothesis that the use of a new-generation implant and advanced, more aggressive hematological care, will result in a decrease rate of complications and better functional results for the haemophilic patients with TKA was tested. The mean age at the time of surgery was 36 years (25 to 44). All the patients were reviewed clinically and radiologically with an average follow-up of 4.4 years (2 to 7 years). At the final follow-up the knee score improved from an average of 23 points (11 to 45) to 86 points (62 to 100; p<0.001). The mean knee flexion contracture improved from 22 degrees (0 degrees to 45 degrees ) to 3 degrees (0 degrees to 10 degrees ; p<0.0001). The mean total flexion arc improved from 69 degrees (5 degrees to 130 degrees ) to 92 degrees (80 degrees to 145 degrees p<0.001). The results of our study confirm that the introduction of modular design may improve the functional results of TKA in haemophilic arthropathy which results in a better range of motion and lower flexion contracture.
对20例血友病患者实施的24例模块化Genesis II（美国田纳西州孟菲斯市施乐辉公司）全膝关节置换术的结果进行了前瞻性评估。我们检验了这样一个假设：使用新一代植入物以及先进、更积极的血液学护理，将使血友病性全膝关节置换患者的并发症发生率降低，并获得更好的功能结果。手术时的平均年龄为36岁（25至44岁）。所有患者均接受了临床和影像学检查，平均随访4.4年（2至7年）。在最后一次随访时，膝关节评分从平均23分（11至45分）提高到86分（62至100分；p<0.001）。平均膝关节屈曲挛缩从22度（0度至45度）改善到3度（0度至10度；p<0.0001）。平均总屈曲弧度从69度（5度至130度）改善到92度（80度至145度；p<0.001）。我们的研究结果证实，模块化设计的引入可能会改善血友病性关节病患者全膝关节置换的功能结果，从而带来更好的活动范围和更低的屈曲挛缩。
