Liu Heng, Wen Li-cheng, Cao Yong-ping, Yang Xin, Ye Yi-lin, Zhang Dao-jian
Department of Orthopeadics, Peking University First Hospital, Beijing, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2012 Dec 18;44(6):882-6.
To observe the incidence of skin sensory loss after total knee arthroplasty (TKA) and its natural history over time, and to identify the relationship between numbness area and incision length, tourniquet time, age and gender.
In the study, 132 patients (20 males and 112 females, with an average age of 69.75 years old, 135 cases of TKA) who underwent primary TKA with midline incisions were chosen and grouped chronologically (4 years, 3 years, 2 years, 1 year, 6 months, 1 month) to the investigation time point from Peking University First Hospital. All the operations were done by the same surgeon team with Stryker NRG and Depuy RP (without patellar resurfacing). Numbness incidence, numbness area, scar length, tourniquet time were recorded from the questionnaires sent to the patients and their medical records.
84.44% of the patients received a reduced skin sensory after TKA, 91.22% of which had a smaller numbness area gradually over time. The numbness area was decreased from the 1 month postoperation group to the 4 years postoperation group (P <0.001). The numbness area in 2 years postoperation group and more were significantly smaller than 1 month postoperation group (P=0.042, 0.004, 0.022), however, the skin flap numbness area had little change after 2 years (P>0.05). The hypoesthesia flap was completely lateral to the incision in 88.60% of the patients, and the numbness area covered the lateral skin and part of media skin to the incision in 11.40% of the patients. Numbness size had no relationship with the patients' gender, age, length of scar and tourniquet time (P>0.05).
Most but not all the patients have a dermal hypoesthesia after total knee arthroplasty. The numbness area will gradually reduce over time. Numbness size is obviously smaller 2 years postoperation and then it will be stable. Gender, age, length of incision, and tourniquet time have no significant relationship with the size of numbness.
观察全膝关节置换术（TKA）后皮肤感觉丧失的发生率及其随时间的自然病程，并确定麻木区域与切口长度、止血带使用时间、年龄和性别的关系。
本研究选取北京大学第一医院132例（男20例，女112例，平均年龄69.75岁，共135例TKA）接受初次TKA且采用中线切口的患者，按从手术到调查时间点的顺序分组（4年、3年、2年、1年、6个月、1个月）。所有手术均由同一手术团队使用史赛克NRG和德普伊RP（不进行髌骨表面置换）完成。通过向患者发放问卷并查阅病历记录，记录麻木发生率、麻木区域、瘢痕长度、止血带使用时间。
84.44%的患者在TKA后出现皮肤感觉减退，其中91.22%的患者麻木区域随时间逐渐缩小。从术后1个月组到术后4年组，麻木区域逐渐减小（P<0.001）。术后2年及以后组的麻木区域明显小于术后1个月组（P=0.042、0.004、0.022），然而，2年后皮瓣麻木区域变化不大（P>0.05）。88.60%的患者感觉减退皮瓣完全位于切口外侧，11.40%的患者麻木区域覆盖切口外侧皮肤及部分内侧皮肤。麻木范围与患者性别、年龄、瘢痕长度和止血带使用时间无关（P>0.05）。
大多数但并非所有患者在全膝关节置换术后出现皮肤感觉减退。麻木区域会随时间逐渐缩小。术后2年麻木范围明显减小，之后趋于稳定。性别、年龄、切口长度和止血带使用时间与麻木范围无显著关系。
