孙铁铮吕厚山 孙铁铮, 副主任医师, 副教授, 硕士研究生导师 年毕业于北京大学, 获得医学博士学位, 在北京大学人民医院关节病诊疗研究中心工作 ; 年曾 赴美国纽约 BethIsrael 医学中心关节病诊疗研究中心进修学习人工关节置换和 关节镜技术 ; ~ 年赴美国哈佛大学麻省总医院骨科研修 目前在北京 大学人民医院关节病诊疗研究中心从事关节疾病的诊断和外科治疗 年和 年连续获得两项国家自然科学基金课题资助, 和 年分别在 JournalofArthroplasty 和 JournalOrthopedicResearch 发表论文 (RA), RA ( ) ( ),, (KSS), ( ),. ( ~ ),. ( ~ ),. ( ~ ), KSS. ( ~ ),.,,,,. ( ~ ),. ( ~ ), KSS ( ~ ),. ( ~ ),. ( ~ ), KSS. ( ~ ),. ( ~ ),,,,,, RA, ; ;, ;,, ; ; ; ;,, DOI:. /cma.j.isn. - X... : : E-mail:lu houshan@yaho.com.cn
( ) ChinJJointSurg(ElectronicEdition), February, Vol., No. Totalkneearthroplastyinrheumatoidstiforankylosed knees SUN Tie-zheng, LU Hou-shan.ArthritisClinicandResearch Center, People shospitalpekinguniversity, Beijing, China Corespondingauthor:LUHou-shan, E-mail:luhoushan@yahoo.com.cn Abstract Objective Toinvestigatetheefectsoftotalkneearthroplastyinlatephaserheumatoidarthritis(RA)withstifor ankylosedknees.methods Aretrospectivestudyoftotalkneearthroplastieswascariedoutin rheumatoidankylosedorstifknees inflexion, andthreerheumatoidankylosedkneesinextension, whichweredonebytheseniorauthorbetwen -.Results Inthegroupof patientswithankylosedkneesinflexion, folow-uptimerangedfrom oneto years(average. years).the averagepostoperativerangeofmotionwas. ( - ), scorewas. ( - )postoperative, andtheaverageextensionlagwas. ( - ).Theaverageknee. morethanthepreoperative.onepatientwithrheumatoidarthritishadasupracondylar fractureduringextension exerciseinpostoperativerehabilitation, andtwopatientshadlate-phaseinfection, whichneeded tobe revised.threepatientshadtransientpalsyofthecommonperonealnervebutrestoredtonormalstateinhalfayearafteroperation.the averagefolow-uptimeofthethreekneesankylosedinextension was. months(rangingfrom sixmonthstonineyears). Radiographsrevealed noinfection, looseningordisplacement, noheterotrophicosificationorstifness.themeanvalueofpreoperativerom was. ( - ), butpost-operativerom was ( - ), sotheoveralimprovementinrom was.. ThemeanKSSscoreimprovedfrom ( - )to. ( - )andthefunctionalscoreimprovedfrom. ( - )to. ( - ).Therewas extensionlaginoneknebecauseofpatelatendonavulsion.therewasonepatientwithskinedgenecrosis, whosewoundhadhealedatdischargebydecreasingtheexerciseintensityandfrequency.therewasanotherkneewithsuperficial woundinfectionatearly-stageaftertheoperation, whichresolvedafterdebridement, tension-decreasingsutureandsensitiveantibiotics. Conclusions AlthoughTKAinanankylosedkneedemandshightechniquesandhasahighrateofcomplications, itisreliablefor achievingpainrelief, increasingrangeofmotion, maintainingstability, andimprovingwalkingabilityinpatientswithstifand ankylosedkneesinflexionorextensionbycarefulselectionofpatients, meticuloussurgicaltechniqueandagressiverehabilitation. Keywords Arthritis, rheumatoid;knee;ankylosis;stif;arthroplasty, replacement, kne (rheumatoidarthritis, RA),,,,,,,, ( ),,,,,,,,, [ ] ~,,,,, RA,,,. ( ~ ) (StrykerScorpio
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( ) ChinJJointSurg(ElectronicEdition), February, Vol., No.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ~,,,,, [ ],,,,, RA,, RA.,, RA,,,,, RA,,,,,,,,,,, [ ] KimYH, Kim JS, ChoSH.Totalkneereplacementafterspontaneousoseousankylosisandtakedownofformalkneefusion.J Arthroplasty,, ( ): -. [ ] SculcoTP.Managementofthestifkne. Calaghan J, RosenbergAG, Rubash HE, etaleds.theadultknee. Philadelphia, PA:LippincotWiliams Wilkins,, -. [ ] BradleyGW, FreemanMA, AlbrektssonBE.Totalprostheticreplacementofankylosedknees.JArthroplasty,, ( ):
-. [ ] RajgopalA, AhujaN, DolaiB.Totalkneearthroplastyinstifandankylosedknees.JArthroplasty,, ( ): -. [ ] TrousdaleRT, HansenAD, RandJA, etal.v-y quadricepsplastyintotalknearthroplasty.clinorthop, ( ): -. [ ] WhitesideLA.Exposureindificulttotalkneearthroplastyusingtibialtubercleosteotomy.ClinOrthop, ( ): -. [ ] GarvinKL, ScuderiG, InsalJN.Evolutionofthequadricepssnip.ClinOrthop, ( ): -. [ ] KimYH, ChoSH, Kim JS.Totalknearthroplastyinbonyankylosisingrossflexion.JBoneJointSurgBr,, ( ): -. ( : - - ) 孙铁铮, 吕厚山. 晚期类风湿关节炎合并膝关节强直或僵直畸形行人工膝关节置换术 [ J/CD]. 中华关节 外科杂志 : 电子版,, ( ): -.