大骨节病与骨关节炎患者行全膝关节置换术后疗效比较

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Abstract Objective Kaschin-beck disease (KBD) is a common musculoskeletal endemic disease in China，in which the knee is the most commonly involved.Total knee arthroplasty (TKA) is often indicated for late stage KBD patients.The purpose of this study was to investigate the satisfaction and clinical results after TKA in patients with KBD.Methods From January 2015 to December 2015，21 patients (28 knees) with KBD who underwent TKA were analyzed retrospectively，with an average age of (60.5±6.00) years old(rang：50~72 years).47 patients (52 knees) with osteoarthritis(OA) who underwent TKA in the same period were selected as the control group，with an average age of (66.3±8.04) years old(rang：52~81 years).The satisfaction of the two groups was compared with the satisfaction scale of the 2011 Knee Society Scoring System.EQ-5D-5L was used to evaluate the health-related quality of life，KSS and WOMAC scores were used to compare the preoperative and postoperative symptoms and activity ability of patients in the two groups.Results The patients in KBD group were followed up for (41.6±3.53)months(from 36 to 48 months)，and patients in OA group were followed up for (40.7±3.40)months(from 36 to 48 months).Except for the age of the patients KBD(60.54±6.0)，OA(66.33±8.04)，(P＜0.05)，there was no significant difference in the baseline data between the two groups.The KSS and WOMAC scores of all patients were significantly improved after operation.The satisfaction score of patients in KBD group was significantly higher than that in OA group (P＜0 05).Further analysis showed that the postoperative walking ability of patients with KBD was inferior to the OA group，and the total score of WOMAC，the score of stiffness and difficulty of daily life of WOMAC in the group of KBD were significant higher than those in the group of OA(P＜0.05).The EQ-5D-5L(P＝0.056)and the total knee score(P＝0.75) were not statistically different between the two groups.Conclusion Although patients with KBD after TKA had inferior clinical outcome than patients with OA，they did have higher satisfaction.This study demonstrates that TKA can significantly improve the symptoms and function of patients with KBD，but how to improve postoperative mobility and stiffness need to be further studied.

Key words： kaschin-Beck disease osteoarthritis total knee arthroplasty

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[1]	. [J]. sygkzz, 2021, 27(4): 377-379.