全膝关节置换术治疗重度膝骨关节炎的临床疗效

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Abstract Objective To discuss the clinical effect of total knee arthroplasty combined with progressive functional exercise to treat severe knee osteoarthritis(KOA) with Parkinson's disease(PD).Methods A retrospective analysis was performed on 28 patients with severe KOA and PD patients admitted to the hospital from June 2015 to December 2016.The patients underwent total knee arthroplasty(TKA) combined with progressive functional exercise.Hospital for Special Surgery(HSS) score，Berg balance scale(BBS) and Fugl-Meyer balance function scale of before surgery，6 months and 1 year after the surgery were recorded.The result was compared.We also observed the complications 1 year after the surgery.Results All 28 patients were followed up.1 patient suffered a knee joint injury due to an accidental fall of 1 year after the operation.2 patients’ PD got worse and had to walk under crutches.The total score of HSS score was (23.56±3.64) before surgery，and raised to(78.49±12.65) 6 months after the surgery and(87.421±15.34) 1 year after the operation.The differences were statistically significant compared with before surgery(P＜0.05).The total score of BBS was (32.58±6.77) before surgery and(47.72±8.24) 6 months after the surgery and (50.13±9.17) 1 year after the operation.The total score of FMB score was (36.57±5.17) before surgery and(43.58±7.19) 6 months after the surgery and(50.13±9.17) score 1 year after the operation.The differences were statistically significant compared with before surgery(P＜0.05).The effective rate of 6 months after surgery and 1 year after surgery were 86.71％ and 96.4％ respectively，and the efficiency of the two groups was measured by rank and test Z＝－1.975，P＝0.048. Conclusion Total knee arthroplasty combined with progressive functional exercise is an effective and safe treatment in severe KOA with PD patients.It has the advantages of less complication，quick recovery of knee joint function and higher dependence，and provides reliable theoretical and evidence-based medical basis for clinical research.

Key words： total knee arthroplasty knee osteoarthritis Parkinson's disease progressive functional exercise

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	Shi Yongtao
	Bai Dongyu
	Cao Bo *

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Shi Yongtao,Bai Dongyu,Cao Bo *. Efficacy of Total Knee Arthroplasty in the Treatment of Severe Knee Osteoarthritis[J]. sygkzz, 2018, 24(9): 778-805.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2018/V24/I9/778

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