Rodríguez-Merchán E C, Magallón M, Galindo E, López-Cabarcos C
International Hemophilia Treatment and Training Center, La Paz University Hospital, Madrid, Spain.
Clin Orthop Relat Res. 1997 Oct(343):63-7.
Sixteen hamstring tenotomies and posterior capsulotomies were assessed retrospectively in 10 patients with hemophilia. The average age of the patients was 17 years (range, 16-24 years). The main indication for surgery was a fixed knee flexion contracture of 30 degrees to 45 degrees, associated with repeated hemarthroses, and failure of conservative treatment after 6 months. A posterior transverse capsulotomy and a Z shaped hamstring tenotomy were performed. The postoperative treatment consisted of repeated stretching exercises for a 6-month period. An average decrease of 25 degrees in the amount of fixed knee flexion contracture was obtained (range, 10 degrees-40 degrees). Followup for an average of 9.5 years showed 11 good, four fair, and one poor result regarding their joint scores. It is concluded that hamstring release is an effective surgical procedure for fixed knee flexion contracture in hemophilia. It seems to reduce the incidence of hemarthrosis relating to such a deformity.
对10例血友病患者的16次腘绳肌肌腱切断术和后关节囊切开术进行了回顾性评估。患者的平均年龄为17岁（范围16 - 24岁）。手术的主要指征是30度至45度的固定性膝关节屈曲挛缩，伴有反复的关节积血，以及6个月保守治疗无效。实施了后横断关节囊切开术和Z形腘绳肌肌腱切断术。术后治疗包括为期6个月的反复伸展运动。固定性膝关节屈曲挛缩量平均减少了25度（范围10度 - 40度）。平均9.5年的随访显示，就关节评分而言，11例结果良好，4例中等，1例差。结论是，腘绳肌松解术是治疗血友病患者固定性膝关节屈曲挛缩的有效手术方法。它似乎能降低与这种畸形相关的关节积血发生率。
