Bae Jung-Kwon, Kim Kang-Il, Lee Sang-Hak, Yoo Myung-Chul
Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, 05278 Korea.
Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul 05278, Korea.
J Clin Med. 2020 Oct 11;9(10):3247. doi: 10.3390/jcm9103247.
While satisfactory results have been reported during short-to mid-term follow-up assessments of hemophilic patients who have undergone total knee arthroplasty (TKA), limited literature focusing on long-term survival following TKA exists to date. As part of this investigation, a consecutive series of 78 TKAs in 56 patients with hemophilic arthropathy was reviewed. The mean patient age at the time of operation was 38.7 years old and the mean length of follow up was 10.2 years. Clinical and radiologic outcomes, quality of life, complications, and long-term survivorship of TKA were evaluated. At the latest point of follow up, the average American Knee Society (AKS) knee and function scores had improved from 32.1 to 85.7 points and 41.5 to 83.3 points, respectively. Moreover, the average range of motion (ROM) was significantly increased from 64.2° preoperatively to 84.2° postoperatively. The physical and mental Short Form-36 results were also significantly improved at the latest point of follow up. Postoperative complications appeared in 12 knees (15.4%). The readmission rate in the 30 days after discharge was 6.4%. Revision TKA was performed in three knees for periprosthetic joint infection ( = 2 knees) and tibial component loosening ( = 1 knee). The Kaplan-Meier 10- and 13-year prosthesis survival rates were 97.1% and 93.2%, respectively. The current study suggests that the mid-to long-term results of TKA in patients with hemophilic arthropathy are favorable, with successful long-term prosthesis survival achievable in most cases.
虽然在接受全膝关节置换术（TKA）的血友病患者的短期至中期随访评估中报告了令人满意的结果，但迄今为止，关注TKA术后长期生存率的文献有限。作为本研究的一部分，回顾了56例血友病性关节病患者连续进行的78次TKA手术。手术时患者的平均年龄为38.7岁，平均随访时间为10.2年。评估了TKA的临床和放射学结果、生活质量、并发症及长期生存率。在最近一次随访时，美国膝关节协会（AKS）的膝关节评分和功能评分分别从32.1分提高到85.7分，从41.5分提高到83.3分。此外，平均活动范围（ROM）从术前的64.2°显著增加到术后的84.2°。在最近一次随访时，简明健康调查简表36（Short Form-36）的身体和心理结果也有显著改善。12个膝关节（15.4%）出现术后并发症。出院后30天内的再入院率为6.4%。因假体周围关节感染（2例）和胫骨组件松动（1例），对3个膝关节进行了TKA翻修手术。Kaplan-Meier法得出的10年和13年假体生存率分别为97.1%和93.2%。目前的研究表明，血友病性关节病患者TKA的中长期结果良好，大多数情况下假体可成功长期存活。
