Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China.
Division of Joint Osteopathy and Traumatology, Center of Orthopedics Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, Guangdong 510000, China.
Chin Med J (Engl). 2023 Jun 20;136(12):1478-1484. doi: 10.1097/CM9.0000000000002677. Epub 2023 May 5.
Total knee arthroplasty (TKA) can reduce severe joint pain and improve functional disability in hemophilia. However, the long-term outcomes have rarely been reported in China. Therefore, this study aimed to evaluate the long-term outcomes and complications of TKA in Chinese patients with hemophilic arthropathy.
We retrospectively reviewed patients with hemophilia who underwent TKA between 2003 and 2020, with at least 10 years of follow-up. The clinical results, patellar scores, patients' overall satisfaction ratings, and radiological findings were evaluated. Revision surgery for implants during the follow-up period was recorded.
Twenty-six patients with 36 TKAs were successfully followed up for an average of 12.4 years. Their Hospital for Special Surgery Knee Score improved from an average of 45.8 to 85.9. The average flexion contracture statistically significantly decreased from 18.1° to 4.2°. The range of motion (ROM) improved from 60.6° to 84.8°. All the patients accepted patelloplasty, and the patients' patellar score improved from 7.8 preoperatively to 24.9 at the last follow-up. There was no statistically significant difference in clinical outcomes between the unilateral and bilateral procedures, except for a better ROM at follow-up in the unilateral group. Mild and enduring anterior knee pain was reported in seven knees (19%). The annual bleeding event was 2.7 times/year at the last follow-up. A total of 25 patients with 35 TKAs were satisfied with the procedure (97%). Revision surgery was performed in seven knees, with 10- and 15-year prosthesis survival rates of 85.8% and 75.7%, respectively.
TKA is an effective procedure for patients with end-stage hemophilic arthropathy, which relieves pain, improves knee functions, decreases flexion contracture, and provides a high rate of satisfaction after more than ten years of follow-up.
全膝关节置换术（TKA）可以减轻血友病患者的严重关节疼痛并改善其功能障碍。然而，在中国，很少有报道长期结果。因此，本研究旨在评估中国血友病性关节炎患者接受 TKA 的长期结果和并发症。
我们回顾性分析了 2003 年至 2020 年间接受 TKA 治疗且随访时间至少 10 年的血友病患者。评估了临床结果、髌骨评分、患者总体满意度评分和影像学发现。记录随访期间假体的翻修手术。
26 例患者的 36 个膝关节接受了 TKA 治疗，平均随访 12.4 年。他们的美国特种外科医院膝关节评分从平均 45.8 分提高到 85.9 分。平均屈曲挛缩从 18.1°统计学显著减少到 4.2°。活动度（ROM）从 60.6°改善到 84.8°。所有患者均接受了髌骨成形术，髌骨评分从术前的 7.8 分提高到最后随访时的 24.9 分。单侧和双侧手术的临床结果除了单侧组随访时的 ROM 更好外，没有统计学差异。7 个膝关节（19%）报告有轻度且持续的膝关节前痛。最后一次随访时，每年出血事件为 2.7 次/年。25 例患者的 35 个膝关节对手术满意（97%）。7 个膝关节进行了翻修手术，10 年和 15 年的假体生存率分别为 85.8%和 75.7%。
TKA 是治疗终末期血友病性关节炎的有效方法，可缓解疼痛，改善膝关节功能，减少屈曲挛缩，并在 10 多年的随访后获得较高的满意度。
Zotero 插件
