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成人膝关节病伴严重骨关节炎全膝关节置换术的结果。

Outcomes of total knee arthroplasty in the adult Kashin-Beck disease with severe osteoarthritis.

机构信息

Department of Orthopaedics, Shaanxi Provincial People's Hospital (the Affiliated Hospital of Xi'an Medical University), Xi'an, 710068, China.

Xi'an Medical University, Xi'an, 710021, China.

出版信息

Int Orthop. 2019 Feb;43(2):323-331. doi: 10.1007/s00264-018-4029-1. Epub 2018 Jul 3.

Abstract

PURPOSE

Kashin-Beck disease (KBD) is an endemic osteoarthropathy, and the severe knee pain and functional limitations were seriously affecting the quality of life in patients with end-stage KBD. We retrospectively evaluated the clinical outcomes and the quality of life in KBD patients with total knee arthroplasty (TKA).

METHODS

A total of 22 subjects (25 knees) suffered KBD with severe knee pain and underwent primary TKA. Knee pain was measured by visual analogue scale (VAS), and the knee function was evaluated by Knee Society Clinical Rating System Score (KSS). KBD Quality of Life (KBDQOL) was used to evaluate the quality of life in KBD patients before and after TKA.

RESULTS

There were no major complications after TKA. The levels of VAS score were obviously deceased in post-operation than that in pre-operation. The levels of KSS score were increased in one year after TKA compared with the pre-operative values, and it maintained a higher level on three years after TKA. The average KBDQOL score level of each domain in pre-operation and one and three years after TKA was increased accordingly. The average scores of physical function, activity limitation, support of society, mental health, and general health in one year after TKA were significantly higher than those in pre-operation.

CONCLUSIONS

TKA can reduce knee pain, improve knee function, and improve the quality life in KBD patients. KBDQOL questionnaire may be a promising instrument for assessing the quality life in KBD patients.

摘要

目的

大骨节病(KBD)是一种地方性骨关节病,晚期 KBD 患者的严重膝关节疼痛和功能受限严重影响生活质量。我们回顾性评估了全膝关节置换术(TKA)治疗末期 KBD 患者的临床疗效和生活质量。

方法

共 22 例(25 膝)严重膝关节疼痛的 KBD 患者接受初次 TKA。采用视觉模拟评分法(VAS)评估膝关节疼痛,采用膝关节协会临床评分系统评分(KSS)评估膝关节功能。采用大骨节病生活质量(KBDQOL)量表评估 TKA 前后 KBD 患者的生活质量。

结果

TKA 后无重大并发症。术后 VAS 评分明显低于术前。TKA 后 1 年 KSS 评分较术前升高,3 年时仍保持较高水平。TKA 前后各领域 KBDQOL 评分均逐渐升高。TKA 后 1 年时,躯体功能、活动受限、社会支持、心理健康和总体健康等各维度的平均得分均明显高于术前。

结论

TKA 可减轻膝关节疼痛,改善膝关节功能,提高 KBD 患者的生活质量。KBDQOL 问卷可能是评估 KBD 患者生活质量的一种有前途的工具。

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