Fehring Thomas K, Odum Susan M, Griffin William L, McCoy Thomas H, Masonis John L
OrthoCarolina Hip and Knee Center, Charlotte, North Carolina, USA.
J Arthroplasty. 2007 Sep;22(6 Suppl 2):62-6. doi: 10.1016/j.arth.2007.03.037. Epub 2007 Jul 27.
The goal of knee arthroplasty is to relieve pain and normalize range of motion while providing stability through the gait cycle. Postoperative, significant (>15 degrees ) flexion contractures can cause persistent pain and altered gait mechanics. This study evaluated the efficacy of revision surgery for painful flexion contractures. Of the 14 patients included in the study, 10 had complete resolution of their flexion contracture. There was significant improvement in extension (P < .0001), flexion (P = .002), and total arc of motion (P < .0001). Knee Society (KSS) pain scores improved significantly (P < .001), whereas KSS function scores did not significantly improve (P = .66). Revision surgery for symptomatic flexion contractures can improve range of motion and diminish pain. The best form of treatment is avoidance through careful flexion and extension gap balancing during primary surgery.
膝关节置换术的目标是缓解疼痛并使活动范围恢复正常，同时在步态周期中提供稳定性。术后，严重（>15度）的屈曲挛缩会导致持续疼痛和步态力学改变。本研究评估了针对疼痛性屈曲挛缩的翻修手术的疗效。在纳入研究的14例患者中，10例患者的屈曲挛缩完全缓解。伸直（P < .0001）、屈曲（P = .002）和总活动弧度（P < .0001）均有显著改善。膝关节协会（KSS）疼痛评分显著改善（P < .001），而KSS功能评分未显著改善（P = .66）。针对有症状的屈曲挛缩进行翻修手术可改善活动范围并减轻疼痛。最佳的治疗方式是在初次手术期间通过仔细平衡屈伸间隙来避免（屈曲挛缩）。
