|
|
Clinical efficacy of total knee arthroplasty in treatment of end-stage Kashin-Beck disease in adults |
NIE Zhijun1 YUAN Qiling2 LING Ming1 CHANG Yanhai1 GUO Xiong3 |
1.Department of Orthopedics, Shaanxi Provincial People′s Hospital the Third Affiliated Hospital of Xi′an Jiaotong University, Shaanxi Province, Xi′an 710068, China; 2.Department of Orthopedics, the First Affiliated Hospital of Xi′an Jiaotong University, Shaanxi Province, Xi′an 710061, China;
3.School of Public Health, Xi′an Jiaotong University Health Science Center, Shaanxi Province, Xi′an 710061, China |
|
|
Abstract Objective To observe the clinical efficacy after total knee arthroplasty (TKA) for the end-stage Kashin-Beck disease (KBD) in adults. Methods From May 2014 to December 2016, in Shaanxi Provincial People's Hospital, 24 patients (29 knees) with the end-stage KBD and treated with total knee arthrophasty (TKA) at first time were selected. Appropriate prosthesis and surgical approach were selected according to patients′ condition. The changes of Visual analogue scale (VAS) score, Knee society score (KSS), knee range of motion (ROM), femorotibial angle (FTA) and postoperative complications were observed before and after TKA, the patients were followed up for 1-15 months. Results In each period after surgery, the VAS score and FTA decreased significantly compared with that before surgery, KSS and ROM increased significantly compared with those before surgery, the differences were statistically significant (P < 0.05). One case occured muscular venous thrombosis, and was cured by anticoagulation therapy. No serious complications were noted, such as pulmonary embolism, deep vein thrombosis, periprosthetic osteolysis, prosthetic sinking or loosening. Conclusion TKA is an effective treatment for end-stage KBD of the knee joint. It can significantly reduce pain of knee joint, and obtain satisfactory activity range and function of the knee joint.
|
|
|
|
|
[1] 郭雄.大骨节病分子生物学与防治研究的新进展及展望[J].中华地方病学杂志,2010,29(5):473-474.
[2] Lü AL,Guo X,Aisha MM,et al. Kashin-Beck disease and Sayiwak disease in China:prevalence and a comparison of the clinical manifestations,familial aggregation,and heritability [J]. Bone,2011,48(2):347-353.
[3] 马静,郭雄,史晓薇,等.大骨节病患者关节软骨基质金属蛋白酶和基质金属蛋白酶组织抑制剂的变化[J].中华地方病学杂志,2015,34(5):344-348.
[4] Fu Q,Cao J,Renner JB,et al. Radiograhic features of hand osteoanhritis in adult Kashin-Beck Disease(KBD):the Yongshou KBD study [J]. Osteoarthritis Cartilage,2015,23(6):868-873.
[5] Huang Q,Zhou ZK,Ma J,et al. The arthropathic and functional impairment features of adult Kashin-Beck disease patients in Aba Tibetan area in China [J]. Osteoarthritis Cartilage,2015,23(4):601-606.
[6] Li Y,Zhou Z,Shen B,et al. Clinical features of Kashin-Beck disease in adults younger than 50 years of age during a low incidence period:severe elbow and knee lesions [J]. Clin Rheumatol,2013,32(3):317-324.
[7] 常彦海,靳占奎,孙正明,等.全膝关节置换术治疗成人严重膝关节大骨节病的疗效评价[J].中华地方病学杂志,2016,35(12):926-930.
[8] 杨雷刚,高大龙,涂忠民,等.后稳定型全膝关节置换术治疗成人膝大骨节病混合畸形[J].中国骨与关节外科,2012,5(3):212-216.
[9] Insall JN,Dorr LD,Scott RD,et al. Rationale of the Knee Society Clinical Rating System [J]. Clin Orthop Relat Res,1989,11(248):13-14.
[10] 中国地方病防治研究中心大骨节病研究所.GB16003-1995 大骨节病诊断标准[S].北京:中国标准出版社,1996.
[11] Mcconnell JS,Shewale S,Munro NA,et al. Reduction of blood loss in primary hip arthroplasty with tranexamic acid or fibrin spray A randomized controlled trial [J]. Acta Orthop,2011,82(6):660-663.
[12] Wang G,Wang D,Wang B,et al. Efficacy and safety evaluation of intra-articular injection of tranexamic acid in total knee arthroplasty operation with temporarily drainage close [J]. Int J Clin Exp Med,2015,8(8):14328-14334.
[13] 中华医学会骨科学分会.中国骨科大手术静脉血栓栓塞症预防指南[J].中华骨科杂志,2016,36(2):65-71.
[14] McCormack HM,Horne DJ,Sheather S. Clinical applications of visual analogue scales:a critical review [J]. Psychological Medicine,1988,18(4):1007-1019.
[15] 刘慧通,凌鸣,常彦海,等.中老年大骨节病性膝关节炎患者膝关节的影像学测量及其临床意义[J].西安交通大学学报:医学版,2013,34(4):520-523.
[16] 吕厚山,关振鹏,袁燕林,等.屈曲位骨性强直的人工全膝关节置换技术与临床效果[J].中华骨科杂志,2002, 22(9):525-530.
[17] 吕厚山,李虎,关振鹏,等.人工全膝关节置换术治疗膝关节伸直位强直畸形[J].中华外科杂志,2007,45(6):405-408.
[18] Tsubosaka M,Takayama K,Oka S,et al. Posterior condylar offset influences the intraoperative soft tissue balance during posterior-stabilized total knee arthroplasty [J]. J Orthop Sci,2017,22(6):1071-1076.
[19] Mito T,Takemoto M,Kawano Y,et al. A case of fulminant myocarditis treated with very long-term support by cardiopulmonary support system [J]. J Cardiol Cases,2016, 14(5):141-144.
[20] 何玄,蔡宏,张克.全膝关节置换术中软组织平衡技术进展[J].中国医药导报,2016,13(9):80-83.
[21] 郭建斌,李坤,王亚康,等.人工全膝关节置换术治疗膝关节外翻畸形[J].中华骨与关节外科杂志,2018,11(1):20-24.
[22] Shah NA,Patil HG,Vaishnav VO,et al. Total knee arthroplasty using subvastus approach in stiff knee:A retrospective analysis of 110 cases [J]. Indian J Orthop,2016, 50(2):166-171.
[23] 冯殿鹏,刘广慧,姜涛.鸡尾酒在膝关节置换术后的应用效果[J].中国当代医药,2017,24(29):103-105. |
|
|
|