Bian Yanyan, Weng Xisheng, Lin Jin, Jin Jin, Qian Wenwei, Zhai Jiliang, Zhao Lijuan
Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Mar;26(3):296-9.
To explore the effectiveness of multiple joint arthroplasty in treating lower limb joint disease.
Between January 2000 and December 2007, 5 patients with lower limb joint disease (three or more joints were involved) were treated with total hip and knee arthroplasty. There were 3 males and 2 females, aged from 27 to 59 years (mean, 41.8 years). Two patients had ankylosing spondylitis and 3 had rheumatoid arthritis, whose hip and knee joints were involved. Four patients lost the ability of walking preoperatively, 1 patient could only walk with crutch. The Harris score was 24 +/- 24 and the Hospital for Special Surgery (HSS) score was 28 +/- 15. All patients underwent multiple joint arthroplasty simultaneously (2 cases) or multiple-stage (3 cases).
Wounds healed by first intention in all patients. In 1 patient who had dislocation of the hip after operation, manipulative reduction and immobilization with skin traction were given for 3 weeks, and no dislocation occurred; in 2 patients who had early sign of anemia, blood transfusion was given. All patients were followed up 46-140 months with an average of 75 months. The patients could walk normally, and had no difficulty in upstairs and downstairs. The stability of the hip and knee was good, and no joint infection or loosening occurred. The Harris score was 88 +/- 6 at last follow-up, showing significant difference when compared with the preoperative score (t = 8.16, P = 0.00); the HSS score was 86 +/- 6, showing significant difference when compared with the preoperative score (t = 13.96, P = 0.00).
Multiple joint arthroplasty is an effective treatment method in patients with lower limb joint disease, which can significantly improve life quality of patients.
探讨多关节置换术治疗下肢关节疾病的有效性。
2000年1月至2007年12月，对5例下肢关节疾病（累及三个或更多关节）患者行全髋和膝关节置换术。其中男性3例，女性2例，年龄27至59岁（平均41.8岁）。2例患者患有强直性脊柱炎，3例患有类风湿关节炎，累及髋和膝关节。4例患者术前丧失行走能力，1例患者仅能拄拐行走。Harris评分24±24，特种外科医院（HSS）评分28±15。所有患者均同时（2例）或分阶段（3例）行多关节置换术。
所有患者伤口均一期愈合。1例患者术后发生髋关节脱位，给予手法复位及皮肤牵引固定3周，未再发生脱位；2例患者有早期贫血迹象，给予输血治疗。所有患者随访46至140个月，平均75个月。患者可正常行走，上下楼梯无困难。髋和膝关节稳定性良好，未发生关节感染或松动。末次随访时Harris评分为88±6，与术前评分相比差异有统计学意义（t = 8.16，P = 0.00）；HSS评分为86±6，与术前评分相比差异有统计学意义（t = 13.96，P = 0.00）。
多关节置换术是治疗下肢关节疾病患者的有效方法，可显著提高患者生活质量。
