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全膝关节置换治疗膝关节高度屈曲畸形的临床研究 党培业1 牛东生 2 白志刚2 【摘 要】 目的 探讨全膝关节置换术(total knee arthroplasty，TKA) 治疗高度膝关节屈曲畸形的临床疗效。方法 收集1997年11月－ 2009年5月12例（20膝）高度膝关节屈曲畸形患者，男3例，女9例，术前、术后HSS评分系统进行评定，判定结果。结果12例均获得随访，随访时间15个月～ 12年，平均37 个月。术前HSS评分平均11.5分（6-24分），术后12月平均79.5分（55-96分），差别有统计学意义（P﹤0.0%），良3例（25.00%），可3例（25.00%），差1例（8.33%）优良率达66.67%。结论 通过精细的术前准备、制定个体化的手术方案，术中注重截骨量与软组织平衡相结合，术后予以系统、规范的管理与康复训练，运用TKA治疗膝关节高度屈曲畸形可以获得满意的疗效。 【关键词】 膝关节 高度屈曲畸形 全膝关节置换术 治疗 Clinical research of total knee arthroplasty in the patients with severe flexion contracture DANG Pei – ye (Ningxia Medical University, Yinchuan 750004, China), NIU Dong – sheng, BAI Zhi – gang (Ningxia People’s Hospital, Yinchuan 750021, China) 【Abstract】Objective To investigeate the clinical effect of severe flexion contracture of TKA（total knee arthroplasty）. Methods The present suday included 12(3 males 9 females) patients with severe flexion contracture from November ,1997 to May ,2009 in Ningxia People’s hospital . HSS score (Hospital for Special Surgery knee score )were used to evaluate the outcome of Surgery before and final follow-up. Results All patients were followed-up from 10 months to 8 years (range 37 months ). The average HSS scores was 11.5(range,6-24) of Surgery before and was 79.5(range, 55-96) of final follow-up. There was statistical difference (P 0.01) Among them, According to the HSS score, 5 patients (41.67%)were rated as excellent, 3 good (25.00%) ，3 fair (25.00%) and 1 Poor efficacy （8.33%）,the choiceness rate was 66.67%. Conclusion Afeter careful preparation of preoperative and setting indiidualized operation schemes.osteotomy combined with the rerelease of contracted soft tissues in the operation,.Giving the rehabilitation training or management of standardize of after surgerys, satisfactory outcome could be obtained in patients with severe flexion contractures who underwent total knee arthroplasty . 【key word】Knee joint Severe flexion contracture Total knee arthroplasty Treatment1997 年11 月－ 2009年5 月