主堡匡堂筮盍垫!垒生!旦!鱼旦笠堑鲞筮!Z塑盟笪墅笪』垦!i塑,墅型!Q:垫!垒,!!!:堑:堂:!!影响全膝关节置换术疗效的术前因素分析张恒岩崔立强翁习生【目的】分析人工全膝关节置换术患者术前相关因素对术后疗效的影响。方法2011年1月至2013年9月北京协和医院骨科全膝关节置换术的患者145例(206膝纳入研究,年龄5l~83(66.5±7.6岁,男22例(3l膝,女123例(175膝。收集患者术前相关数据资料(性别、年龄、体质指数、术前关节活动度、内翻畸形程度、术前屈曲畸形程度、术前HSS评分并与术后膝关节HSS评分及术后关节活动度行相关性统计学分析。结果术后平均随访35(24~56个月。HSS评分由术前(55.1±7.6分提高到术后(89.3±5.1分,活动度由术前(95.6±10.0。改善至术后(115.1±7.8o。多因素分析显示,术后关节活动度与术前关节活动度呈正相关(r=0.209,P<0.01,与体质指数、内翻畸形程度呈负相关r=一0.864、一0.353,均P<0.01;术后HSS评分与术前关节活动度、术前HSS评分呈正相关(r=0.101、0.244,P=0.033,与患者的体质指数呈负相关(r=一0.277,P=0.039。结论全膝关节置换能有效改善膝关节的功能。患者体质指数、术前关节活动度、内翻畸形程度及术前HSS评分对术后膝关节功能存在影响。【关键词】关节成形术,置换,膝;骨关节炎,膝;膝关节;治疗结果;因素分析,统计学基金项目:国家自然科学基金(81000817Effl地tofpreoperativefactorsontheclinicaloutcomeoftotalkneearthropgastyZhangttengyan,Cui厶g泌昭,贶,lgXisheng.DepartmentofOrthopedics,PekingUnionMedicalCollegeHospital,PekingUnionMedicalCollege.ChineseAcademyofScience,ijing10073D,ChinaCorrespondingauthor:Weng麟k唱,Email:sunlit_365@sina.corn【Abstract】0bjectiveToanalyzetheeffectofpreoperativefactorsontheclinicaloutcomeinpatientsreceivingtotalkneereplacement.MethodsFromJanuary2011IoSeptember2013.145patients(206knees;22males,31knees;123females,175kneesreceivingtotalkneearthroplastyweresuccessfullyincludedinthisstudyandfollowedup.7111eaverageageswas(66.54-7.6yearsold(range,51—83yearsold.Thedataofpreoperativefactorsineludedgender,age,bodymassindex(BMI,preoperativerangeofmotion(ROM,thekneevarusangle,flexiondeformityandpreoperativethehospitalforspecialsurgery(HSSscorewerecollected.necorrelationbetweenpreoperativefactorsandtheclinicaloutcome(postoperativeHSSscore,postoperativeROMaftertotalkneereplacementwasevaluatedstatistically.ResultsTheaveragefollouptimeWas35months(range,24—56months.TheHSSSCOrewasincreasedfrom(55.1±7.6preoperativelyto(89.3±5.1postoperatively.ROMelevatedfrom(95.6±10.0。preoperativelyto(115.14-7.8opostoperatively.ThecorrelationanalysisshowedthatthepostoperativeROMWaspositivelycorrelatedwiththepreoperativeROM,andwasnegativelycorrelatedwiththeBMI,thekneevarusangle(r=一0.864,一0.353,allP<0.01.ThepostoperativeHSSscoreWaSpositivelycorrelatedwithpreoperativeROM,preoperativeHSSscore(r=0.101,0.244,P=0.033,P<0.01,andWaSnegativelycorrelatedwiththeBMI(r=一0.277。P=0.039.ConclusionsTotalkneearthroplastycalldefinitelyimprovethefunotionofkneejoint.TheBMI,thepreoperativeROM,thekneevardsangleandpreoperativeHSSSCOIfehaveinfluenceonpostoperativefunctionofpatientsreceivingtotalkneearthroplasty.【Keywords】Arthreplasty,replacement,knee;Osteoarthritis,knee;Kneejoint;Treatmentoutcome;Factorsanalysis,statisticalFundprogrmn:NationalNaturalScienceFoundationofChina(81000817人工全膝关节置换术(TKA已成为终末期膝DOI:10.3760/cma.j.issn.0376-2491.2016.17.009作者单位:100730中国医学科学院北京协和医学院北京协和医院骨科通信作者:翁习生,Email:sunlit_.365@sina・1345・.临床研究.关节骨关节炎外科治疗的主要方式之一。TKA长期疗效值得肯定,全膝关节置换术后15年的假体生存率可达95%‘以...