摘要
背景:大骨节病(KBD)最常受累关节为膝关节,表现为对称性多关节疼痛和晨僵、肌肉萎缩、关节增大和/或变形、活动度下降。病变晚期常需要行全膝关节置换术(TKA),然而关于其疗效报道较少。目的:评价TKA治疗KBD的临床疗效并进行相关性分析。方法:回顾性分析2008年9月至2018年6月行TKA术的77例KBD患者资料,其中男22例,女55例,年龄45~80岁,平均(65.1±8.8)岁。比较术前和末次随访患者的疼痛视觉模拟评分(VAS)、膝关节活动度(ROM)、膝关节评分(HSS)、简明健康状况量表(SF-36)评分,并进行相关性分析。结果:所有患者随访14~132个月,平均(72.7±37.6)个月。术前VAS评分7.3±0.7,末次随访为1.1±0.5;术前ROM 75.5°±19.0°,末次随访为105.8°±11.3°;术前HSS评分36.4±9.6,末次随访为92.1±4.3;术前SF-36(生理健康内容)评分4.9±3.7,末次随访为36.9±6.4分;术前SF-36(心理健康内容)评分26.3±4.8,末次随访为55.2±8.2。末次随访时VAS评分较术前降低,其余评分均较术前提高(P<0.05)。手术前后解剖股胫角(aFTA)、解剖股骨远端外侧角(aLDFA)、解剖胫骨近端内侧角(a MPTA)均得到明显改善(P<0.05)。在相关性分析中术前患者疼痛程度、关节功能、生活质量与末次随访临床结果存在相关性;患者的性别、年龄、BMI、术后假体角度与末次随访临床结果无相关性。结论:KBD患者行TKA后能够明显缓解疼痛,改善关节功能,提高生活质量。对于晚期KBD患者建议行关节置换手术。术后临床结果与术前患者的疼痛程度、关节功能、生活质量相关。
Background:Kaschin-Beck disease(KBD)commonly affects knee joints characterized by symmetrical multiple joints pain and morning stiffness,muscle atrophy,joint enlargement and/or deformation and decease of range of motion(ROM).Total knee arthroplasty(TKA)is often required in the late stage of the disease,but there are few reports on its efficacy.Objective:To evaluate the clinical efficacy of total knee arthroplasty(TKA)in the treatment of osteoarthritis of KBD and the correlation.Methods:Data of 77 patients with KBD who underwent TKA from September 2008 to June 2018 were retrospectively analyzed including 22 males and 55 females with an average age of(65.1±8.8)years(range,45-80 years).VAS score,ROM,HSS score and SF-36 score were compared between pre-operation and the last follow-up,and the correlation analysis was conducted.Results:All patients were followed up for 14-132 months with(72.7±37.6)months on average.VAS score was 7.3±0.7 and 1.1±0.5;ROM was 75.5°±19.0°and 105.8°±11.3°;HSS score was 36.4±9.6 and 92.1±4.3;the scores of SF-36(physical health content)was 4.9±3.7 and 36.9±6.4;the scores of SF-36(mental health content)was 26.3±4.8 and 55.2±8.2 before operation and at the last follow-up.At the last follow-up,VAS score was significantly lower and the other indexes were all significantly higher than those before operation(P<0.05).The anatomic femoral tibial angle(aFTA),anatomic lateral distal femoral angle(aLDFA)and anatomic medial proximal tibial angle(aMPTA)were significantly improved after operation(P<0.05).In the correlation analysis,preoperative pain degree,joint function,quality of life were associated with the clinical outcomes;gender,age,BMI,and the angles of knee prosthesis had no association with clinical outcomes.Conclusions:Patients with KBD undergoing primary TKA have pain significantly relieved,and joint function and the quality of life improved.For patients with advanced Kashin-Beck disease,joint replacement surgery is recommended.Preoperative pain degree,joint function and quality of life were associated with the clinical outcomes.
作者
刘慧敏
王亚飞
武健民
于聪
廉永云
LIU Huimin;WANG Yafei;WU Jianmin;YU Cong;LIAN Yongyun(Department of Orthopaedic Surgery,Fourth Affiliated Hospital of Harbin Medical University,Harbin 150000,China)
出处
《中华骨与关节外科杂志》
2021年第4期258-262,共5页
Chinese Journal of Bone and Joint Surgery
基金
哈尔滨医科大学第四临床医学院院长基金(HYDSYYZ201504)
关键词
关节置换
大骨节病
临床疗效
Arthroplasty
Kashin-Beck Disease
Clinical Efficacy
