Yoshino S, Fujimori J, Morishige T, Uchida S
Arch Orthop Trauma Surg (1978). 1984;103(1):1-4. doi: 10.1007/BF00451311.
Between 1973 and 1981, bilateral total replacement of hip and knee joints was performed in 22 patients with rheumatoid arthritis. During follow-up, 2 patients died of diseases not directly related to the operation. Besides these patients, there were 2 patients who could not be followed up. The remaining 18 patients constituted the subjects for study. We studied the postoperative results, emphasing improvement in the ability to perform everyday activities. Walking ability was improved in 16 patients. There was an increase in the number of patients able to rise from a chair, go up and down stairs, and get in and out of a car, bus or train. Of the 14 married patients (not including 2 patients who were unable to walk and 5 patients over 60 years of age) 7 were able to perform sexual intercourse as well as they had been able to when healthy. The patients who underwent bilateral total replacement of hip and knee joints often presented various problems, for example with regard to indications, the operative technique to use, as well as complications such as heart disease, pulmonary disease, and secondary amyloidosis. We have found, however, that bilateral total replacement of hip and knee joints can accomplish the operative objectives of eliminating pain and improving the quality of daily life in severely handicapped rheumatoid patients.
1973年至1981年间，对22例类风湿性关节炎患者实施了双侧髋关节和膝关节全置换术。在随访期间，2例患者死于与手术无直接关系的疾病。除这些患者外，还有2例患者无法进行随访。其余18例患者构成研究对象。我们研究了术后结果，重点是日常活动能力的改善。16例患者的行走能力得到改善。能够从椅子上起身、上下楼梯以及进出汽车、公共汽车或火车的患者人数有所增加。在14例已婚患者中（不包括2例无法行走的患者和5例60岁以上的患者），7例患者能够像健康时一样进行性生活。接受双侧髋关节和膝关节全置换术的患者经常出现各种问题，例如适应症、所采用的手术技术以及心脏病、肺病和继发性淀粉样变性等并发症。然而，我们发现，双侧髋关节和膝关节全置换术能够实现消除疼痛和改善重度残疾类风湿患者日常生活质量的手术目标。
