全膝关节置换术后严重异位骨化与关节僵硬
全膝关节置换,,全膝关节置换;,异位骨化;,僵硬,摘要,关键词,1资料和方法,2结果,3讨论,参考文献
摘 要：[目的]探讨全膝关节置换术后严重异位骨化与关节僵硬的关系。[方法]对420例接受全膝关节置换术的患者随访，其中9例出现了Ⅲ级异位骨化，分别测量并记录该9例患者术后2周、12个月的疼痛评分和膝关节活动度，拍摄X线片，测量异位骨的大小。随机抽取9例无异位骨化的关节置换术后患者作为对照组，并测量疼痛评分及活动度。分别将异位骨化组和对照组的结果进行对比。[结果]关节置换术后Ⅲ级异位骨化的发病率为21%，X线片显示异位骨>5 cm，侵及股四头肌，引起关节疼痛。异位骨化组术后2周疼痛评分平均256分，关节最大伸直角度平均11°，最大屈曲角度1191°，与对照组比较差异均无统计学意义(P>005)。异位骨化组术后12个月疼痛评分平均1556分，低于术后2周(P<001)，与对照组术后12个月(25分)比较有显著差异(P<001)。关节活动度：伸直61°，屈曲917°与术后2周和对照组术后12个月比较均有显著差异(P<001)。[结论]全膝关节置换术后Ⅲ级异位骨化可以导致关节疼痛和活动度受限，是术后关节僵硬的原因之一，严重影响置换术后临床效果。
关键词：全膝关节置换; 异位骨化; 僵硬
中图分类号 R681
Hard heterotopic ossification and knee stiff after total knee arthroplasty
CHEN Baicheng,GAO Shijun,SUN Ran,et al.
Joint Surgery,the Third Hospital of Hebei Medical University,Shijiazhuang 050051
Abstract：[Objective]To study the relation between hard heterotopic ossification after TKA and knee stiff.[Method]A total of 420 TKA patients were followed up.A total of 9 knees showed type Ⅲ heteroropic ossification .Postoperative range of motion,pain scores and X ray were obtained at 2 weeks and 12 months.Random sample of 9 knees without heteroropic ossification as control group.[Result]The rate of type Ⅲ heteroropic ossification after TKA was 2.1%,the size was larger than 5cm,the new bone invaded extensor mechanism and lead to pain in knee.Two weeks after TKA,the pain scores of HO group were 25.6,the degree of extend was 1.1°,the degree of flection was 119.1°. There were no differencets between HO group and comparison group (P>0.05) .Twelve months after TKA, the pain score of HO group was 15.56,lower than 2 weeks and comparison group in 12 months (P<0.01).The degree of extend was 6.1°, flection was 91.7°.There was statistically significance campaired with 2 weeks and comparison group(P<0.01).[Conclusion]Ⅲ heteroropic ossification after TKA leads to knee pain and limit of range of motion. It is one of the reasons lead to knee stiff. ......
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