Fosco M, Filanti M, Amendola L, Savarino L M, Tigani D
Department of Orthopaedic Surgery, Rizzoli Orthopaedic Institute, University of Bologna, Via Pupilli 1, 40136 Bologna, Italy.
Musculoskelet Surg. 2011 Apr;95(1):7-12. doi: 10.1007/s12306-011-0099-6. Epub 2011 Mar 9.
This retrospective study was done to evaluate the results of total knee arthroplasty performed on 32 patients with stiff knee, having a preoperative arc of movement between 0° and 50° (average 30°). This group of patients were matched with a group of 32 flexible knees, randomly selected from the same cohort of patients who underwent knee arthroplasty in our ward. At a mean follow-up of 4.5 years (min 2, max 11 years), seven patients of the stiff group reported complications (21.8% overall): four prosthetic infection that successively underwent removal of the implant, one skin necrosis 4 months after the intervention, one early contracture and one late stiffness of the knee. In the control group, in two cases, there was substitution of the implant due to periprosthetic infection. At the end of the study period, the clinical evaluation was not possible in four patients of the stiff and in two patients of the control group who underwent revision of the prosthetic components. An excellent or good clinical result was obtained in 92% of stiff group and in 96% of the control group patients. Although the final results achieved in these patients are worse than those of patients with flexible knee due to disadvantageous preoperative conditions and high complication rate, our results demonstrate the efficacy of the arthroplasty procedure as treatment of stiff knee.
本回顾性研究旨在评估对32例膝关节僵硬患者行全膝关节置换术的结果，这些患者术前活动弧度在0°至50°之间（平均30°）。该组患者与从我们病房接受膝关节置换术的同一队列患者中随机选取的32例膝关节活动灵活的患者进行匹配。平均随访4.5年（最短2年，最长11年），僵硬组有7例患者报告出现并发症（总体发生率为21.8%）：4例假体感染，随后进行了假体移除；1例术后4个月出现皮肤坏死；1例早期膝关节挛缩和1例晚期膝关节僵硬。在对照组中，有2例因假体周围感染而更换了假体。在研究期末，僵硬组有4例患者和对照组有2例患者进行了假体部件翻修，无法进行临床评估。僵硬组92%的患者和对照组96%的患者获得了优良的临床结果。尽管由于术前条件不利和并发症发生率高，这些患者最终取得的结果比膝关节活动灵活的患者差，但我们的结果证明了关节置换术作为治疗膝关节僵硬的有效性。
