Qi Jin, Sang An-Min, Qiu Wu-Yi, Wang Xu
Department of Orthopaedics, the Second Affiliated Hospital of Lanzhou University, Lanzhou 730030, Gansu, China;
Zhongguo Gu Shang. 2019 Nov 25;32(11):1066-1071. doi: 10.3969/j.issn.1003-0034.2019.11.018.
To explore clinical results of ipsilateral total knee and hip arthroplasty at stage I for the treatment of ipsilateral hip and knee diseases.
From January 2008 to September 2016, 7 patients with ipsilateral knee and hip disease were treated by simultaneous total knee and hip arthroplasty at stage I, including 4 males and 3 females aged from 47 to 68 years old, the courses of disease ranged from 6 to 29 years; 3 patients with rheumatoid arthritis, 3 patients with ankylosing spondylitis, and 1 patient with senile hip and knee arthritis. Operation time, intraoperative blood loss and local wounds during hospitalization were observed and recorded, and Harris hip score and HSS knee score were used to evaluate therapeutic effects.
Seven patients were followed up from 6 to 24 months, operative time ranged from 297 to 362 min, blood loss ranged from 300 to 780 ml. Harris hip score before operation ranged from 27.67 to 39.11, 75.32 to 85.10 at 6 months after operation; 3 patients were good and 4 patients moderate. HSS knee score before operation ranged from 40.90 to 51.36, and 73.56 to 85.33 at 6 months after operation; 1 patients were excellent and 6 patients good. No periprosthetic fracture, aseptic loosening and periprosthetic infection occurred in 7 patients.
Ipsilateral total knee and hip arthroplasty at stage I for the treatment of hip and knee disease could restore hip and knee function as soon as possible and recover function of hip and knee to the maximum degree, make patients get down the bed earlier, effectively reduce the complications caused by long-term bedridden, and improve patient's quality and satisfaction of life. While the quality of double-joint arthroplasty at stage I need higher technical requirements which should strengthen the management of the perioperative period, and strictly grasped indications.
探讨同期一期行同侧全膝关节置换术与全髋关节置换术治疗同侧髋、膝关节疾病的临床效果。
2008年1月至2016年9月,对7例同侧髋、膝关节疾病患者同期一期行全膝关节置换术与全髋关节置换术,其中男4例,女3例,年龄47~68岁,病程6~29年;类风湿关节炎3例,强直性脊柱炎3例,老年性髋、膝关节炎1例。观察并记录手术时间、术中出血量及住院期间局部伤口情况,采用Harris髋关节评分及HSS膝关节评分评价治疗效果。
7例患者均获随访,随访时间6~24个月,手术时间297~362分钟,出血量300~780毫升。术前Harris髋关节评分为27.67~39.11分,术后6个月为75.32~85.10分;优3例,良4例。术前HSS膝关节评分为40.90~51.36分,术后6个月为73.56~85.33分;优1例,良6例。7例患者均未发生假体周围骨折、无菌性松动及假体周围感染。
同期一期行同侧全膝关节置换术与全髋关节置换术治疗髋、膝关节疾病可尽早恢复髋、膝关节功能,最大限度恢复髋、膝关节功能,使患者早期下床,有效减少长期卧床引起的并发症,提高患者生活质量及满意度。一期双关节置换术对手术质量要求较高,应加强围手术期管理,严格掌握手术适应证。