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Ⅰ期同侧人工髋膝关节置换术的疗效分析
Hits: 1803   Download times: 945   Received:April 16, 2019    
作者Author单位UnitE-Mail
齐进 QI Jin 兰州大学第二医院骨科, 甘肃 兰州 730030 Department of Orthopaedics, the Second Affiliated Hospital of Lanzhou University, Lanzhou 730030, Gansu, China 815018560@qq.com 
桑安民 SANG An-min 舟曲县人民医院骨科, 甘肃 甘南 746300  
仇五一 QIU Wu-yi 舟曲县人民医院骨科, 甘肃 甘南 746300  
王旭 WANG Xu 兰州大学第二医院骨科, 甘肃 兰州 730030 Department of Orthopaedics, the Second Affiliated Hospital of Lanzhou University, Lanzhou 730030, Gansu, China  
期刊信息:《中国骨伤》2019年32卷,第11期,第1066-1071页
DOI:10.3969/j.issn.1003-0034.2019.11.018
基金项目:国家自然科学基金(编号:31801194);甘肃省自然科学基金(编号:18JR3RA325)


目的:探讨Ⅰ期同侧人工髋、膝关节置换术治疗髋、膝关节病的临床疗效。

方法:自2008年1月至2016年9月,采用Ⅰ期同侧人工髋、膝关节置换术治疗7例髋、膝关节病患者,男4例,女3例;年龄47~68岁;病程6~29年;其中类风湿性关节炎3例,强直性脊柱炎3例,老年性髋膝关节炎1例。观察并记录患者的手术时间、出血量、住院期间局部伤口情况,并分别采用Harris髋关节评分和膝关节HSS评分进行髋膝关节功能评分。

结果:7例患者均获随访,时间6~24个月。患者手术时间297~362 min,出血量300~780 ml。Harris髋关节评分由术前的27.67~39.11分提高至术后6个月的75.32~85.10分,其中良3例,可4例;膝关节HSS评分由术前的40.90~51.36分提高至术后6个月的73.56~85.33分,其中优1例,良6例。7例患者术后均未出现假体周围骨折、假体无菌性松动、假体周围感染。

结论:Ⅰ期同侧髋、膝关节置换术治疗同侧髋、膝关节疾病患者可以尽早及最大程度地恢复髋、膝关节功能,使患者早期下床负重,有效降低患者长期卧床而产生的并发症,提高患者生存质量及满意度,但是Ⅰ期双关节置换术技术要求高,同时需加强围手术期的管理,严格掌握适应证。
[关键词]:髋关节  膝关节  关节成形术,置换
 
Curative effect analysis of ipsilateral total knee and hip arthroplasty at stageⅠ
Abstract:

Objective: To explore clinical results of ipsilateral total knee and hip arthroplasty at stage I for the treatment of ipsilateral hip and knee diseases.

Methods: From January 2008 to September 2016,7 patients with ipsilateral knee and hip disease were treated by simultaneous total knee and hip arthroplasty at stageⅠ,including 4 males and 3 females aged from 47 to 68 years old,the courses of disease ranged from 6 to 29 years;3 patients with rheumatoid arthritis,3 patients with ankylosing spondylitis,and 1 patient with senile hip and knee arthritis. Operation time,intraoperative blood loss and local wounds during hospitalization were observed and recorded,and Harris hip score and HSS knee score were used to evaluate therapeutic effects.

Results: Seven patients were followed up from 6 to 24 months,operative time ranged from 297 to 362 min,blood loss ranged from 300 to 780 ml. Harris hip score before operation ranged from 27.67 to 39.11,75.32 to 85.10 at 6 months after operation;3 patients were good and 4 patients moderate. HSS knee score before operation ranged from 40.90 to 51.36,and 73.56 to 85.33 at 6 months after operation;1 patients were excellent and 6 patients good. No periprosthetic fracture,aseptic loosening and periprosthetic infection occurred in 7 patients.

Conclusion: Ipsilateral total knee and hip arthroplasty at stageⅠfor the treatment of hip and knee disease could restore hip and knee function as soon as possible and recover function of hip and knee to the maximum degree,make patients get down the bed earlier,effectively reduce the complications caused by long-term bedridden,and improve patient's quality and satisfaction of life. While the quality of double-joint arthroplasty at stageⅠneed higher technical requirements which should strengthen the management of the perioperative period,and strictly grasped indications.
KEYWORDS:Hip joint  Knee joint  Arthroplasty,replacement
 
引用本文,请按以下格式著录参考文献:
中文格式:齐进,桑安民,仇五一,王旭.Ⅰ期同侧人工髋膝关节置换术的疗效分析[J].中国骨伤,2019,32(11):1066~1071
英文格式:QI Jin,SANG An-min,QIU Wu-yi,WANG Xu.Curative effect analysis of ipsilateral total knee and hip arthroplasty at stageⅠ[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(11):1066~1071
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