Schurman D J, Parker J N, Ornstein D
J Bone Joint Surg Am. 1985 Sep;67(7):1006-14.
The factors influencing the range of motion of the knee after total condylar knee replacement were analyzed in fifty-five consecutive patients who had seventy-one replacements and a minimum follow-up of two years. Statistically significant improvement in flexion occurred between the first postoperative evaluation in the hospital, the evaluation at discharge, and the evaluations at three months and one year after replacement. Postoperative range of motion was not influenced by the patient's gender, by the extent of the disease (monoarticular in comparison with polyarticular), or by treatment with a unilateral or bilateral procedure. The knees of patients with rheumatoid arthritis gained extension at the expense of flexion. The average flexion arcs of the knees with rheumatoid arthritis and of those with osteoarthritis were the same two years after operation as they had been preoperatively. Knees with preoperative flexion of more than 100 degrees had lost flexion at follow-up, whereas those with preoperative flexion of less than 100 degrees had gained flexion. Significant improvement in extension occurred only before discharge. For the patients whose preoperative flexion contracture was 10 degrees or more, virtually all improvement in the contracture occurred at the time of surgery. Patients who had a simultaneous bilateral total knee replacement did as well as those with a single knee replacement.(ABSTRACT TRUNCATED AT 250 WORDS)
对55例连续患者的71次全髁膝关节置换术后影响膝关节活动范围的因素进行了分析，这些患者至少随访两年。术后首次在医院评估、出院时评估以及置换后3个月和1年评估时，屈曲角度有统计学意义的显著改善。术后活动范围不受患者性别、疾病程度（单关节与多关节相比）或单侧或双侧手术治疗的影响。类风湿性关节炎患者的膝关节以牺牲屈曲为代价获得伸展。类风湿性关节炎患者的膝关节和骨关节炎患者的膝关节在术后两年的平均屈曲弧度与术前相同。术前屈曲超过100度的膝关节在随访时失去了屈曲，而术前屈曲小于100度的膝关节则获得了屈曲。仅在出院前伸展有显著改善。对于术前屈曲挛缩为10度或更大的患者，挛缩的几乎所有改善都发生在手术时。同期进行双侧全膝关节置换的患者与单侧膝关节置换的患者效果相同。（摘要截短于250字）
