肥胖患者膝关节置换的挑战与近期疗效分析

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Abstract Objective To explore the possible problems and evaluate the short-term outcome post-operation of total knee replacement in obese patients.Methods We researched 23 cases (28 knees) of the total knee replacement in treating end-stage gonarthrosis combined with obesity，and compared with the randomly selected23 cases (24 knees) of the total knee replacement in the nonobese patients.All were treated by the same surgeons from november 2011 to september 2014.Pre-and post-operative evaluations were performed with Knee Society Scoring System in the both experimental and control group.All the patients were averagely followed up for averaged 15.2 months，ranged from 2 to 18 months.Results There were significant difference of KSS clinical score (P＜0.05) and no significant difference of kss function score(P＞0.05)between the two groups at preoperative time.At the last follow-up，there was no significant difference of KSS score(P＞0.05)，but the score was improved obviously compared with the preoperative conditions (P＜0.05).After surgery，one case had incision fat liquefaction resulting to delayed healing，and one had lower limbs deep venous thrombosis because of not using anticoagulant drugs according to requirements.All the patients with complications recovered after the treatment.Conclusion End-stage gonarthrosis patients combined with obesity，they can have achieve satisfactory short-term clinical curative effect through reasonable treatment of preoperative complications.Skilled operating technology and systematic Postoperative management are key to get good clinical results.

Key words： obesity total knee replacement short-term outcome

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［1］Vasarhelyi EM，MacDonald SJ.The influence of obesity on total joint arthroplasty［J］.J Bone Joint Surg(Br)，2012，94(11 Suppl A)：100-102.
［2］Kurtz S，Ong K，Lau E，et al.Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030［J］.J Bone Joint Surg(Am)，2007，89(4)：780-785.
［3］Sowers MR，KarvonenGutierrez CA.The evolving role of obesity in knee osteoarthritis［J］.Curr Opin Rheumatol，2010，22(5)：533-537.
［4］Muthuri SG，Hui M，Doherty M，et al.What if we prevent obesity? Risk reduction in knee osteoarthritis estimated through a meta-analysis of observational studies［J］.Arthritis Care Res (Hoboken)，2011，63(7)：982-990.
［5］Losina E，Walensky RP，Reichmann WM，et al.Impact of obesity and knee osteoarthritis on morbidity and mortality in older Americans［J］.Ann Intern Med，2011，154(4)：217-226.
［6］Wright TM，Maher SA.Current and novel approaches to treating chondral lesions［J］.J Bone Joint Surg(Am)，2009，91(Suppl 1)：120-125.
［7］Goodfellow J，O'Connor J，Murray DW.The Oxford meniscal unicompartmental knee［J］.J Knee Surg，2002，15(4)：240-246.
［8］Insall JN，Dorr LD，Scott RD，et al.Rationale of the knee society clinical rating system［J］.Clin Orthop Relat Res，1989(248)：13-14.
［9］尹海波，孙俊英，赵锡江，等.全膝置换术治疗类风湿与退变性膝关节炎的比较研究［J］.实用骨科杂志，2017，23(2)：128-133.
［10］Samson AJ，Mercer GE，Campbell DG.Total knee replacement in the morbidly obese：a literature review［J］.ANZ J Surg，2010，80(9)：595-599.
［11］Rajgopal V，Bourne RB，Chesworth BM，et al.The impact of morbid obesity on patient outcomes after total knee arthroplasty［J］.J Arthroplasty，2008，23(6)：795-800.
［12］Mulhall KJ，Ghomrawi HM，Mihalko W，et al.Adverse effects of increased body mass index and weight on survivorship of total knee arthroplasty and subsequent outcomes of revision TKA［J］.J Knee Surg，2007，20(3)：199-204.
［13］Bordini B，Stea S，Cremonini S，et al.Relationship between obesity and early failure of total knee prostheses［J］.BMC Musculoskelet Disord，2009(10)：29.
［14］Kerkhoffs GM，Servien E，Dunn W，et al.The influence of obesity on the complication rate and outcome of total knee arthroplasty：a metaanalysis and systematic literature review［J］.J Bone Joint Surg(Am)，2012，94(20)：1839-1844.
［15］Dowsey MM，Liew D，Stoney JD，et al.The impact of pre-operative obesity on weight change and outcome in total knee replacement：a prospective study of 529 consecutive patients［J］.J Bone Joint Surg(Br)，2010，92(4)：513-520.
［16］Jarvenpaa J，Kettunen J，Kroger H，et al.Obesity may impair the early outcome of total knee arthroplasty［J］.Scand J Surg，2010，99(1)：45-49.
［17］Gandhi R，Wasserstein D，Razak F，et al.BMI independently predicts younger age at hip and knee replacement［J］.Obesity (Silver Spring)，2010，18(12)：2362-2366.

[1]	. [J]. sygkzz, 2021, 27(4): 366-370.