Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada.
J Arthroplasty. 2012 Sep;27(8):1437-41. doi: 10.1016/j.arth.2011.12.015. Epub 2012 Jan 27.
A retrospective case-control study was conducted to evaluate 1-year total knee arthroplasty (TKA) outcomes among preoperative stiff knees, range of motion (ROM) 80° or less, compared with nonstiff preoperative knees, ROM 100° or greater. A total of 134 stiff knee cases were compared with a matched cohort of 134 non-stiff knee controls. Knee Society Score and Oxford Knee Score change scores from baseline to 1 year were similar between the groups. Stiff knees experienced a significantly greater mean improvement in ROM from baseline to 1 year (30.8° ± 18.8°) as compared with nonstiff knees (1.1° ± 12.8°) (P < .0001). Although ultimate ROM of a TKA can be restricted secondary to preoperative stiffness, improvements in outcomes and ROM are not affected. We conclude that progression of stiffness should not in and of itself lead to earlier intervention of TKA in most cases.
一项回顾性病例对照研究评估了术前膝关节僵硬（活动度 ROM 80°或以下）与术前非僵硬（ROM 100°或以上）患者 1 年全膝关节置换术（TKA）的总体结果。共有 134 例膝关节僵硬病例与 134 例匹配的非僵硬膝关节对照组进行比较。两组患者的膝关节协会评分和牛津膝关节评分从基线到 1 年的变化评分相似。与非僵硬膝关节相比，僵硬膝关节在从基线到 1 年的 ROM 中具有显著更大的平均改善（30.8°±18.8°）（P<.0001）。尽管 TKA 的最终 ROM 可能因术前僵硬而受到限制，但结果和 ROM 的改善不受影响。我们的结论是，在大多数情况下，僵硬的进展本身不应导致 TKA 的早期干预。
