全膝关节置换术后膝关节不稳定危险因素评估

吴晓光; 谢峰

doi:10.16016/j.1000-5404.202101013

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全膝关节置换术后膝关节不稳定危险因素评估

临床医学 | 更新时间：2026-01-09

- 全膝关节置换术后膝关节不稳定危险因素评估
- Risk factors for knee instability after total knee arthroplasty surgery
- 第三军医大学学报 2021年43卷第13期页码：1263-1268
- 作者机构：
  
  1.471000 河南洛阳，联勤保障部队第989医院关节脊柱科
  2.401120 重庆，重庆医科大学附属第三医院骨与创伤中心
- 作者简介：
  
  [谢峰，E-mail: xiefenglove@163.comXIE Feng, E-mail: xiefenglove@163.com
- 基金信息：
- DOI：10.16016/j.1000-5404.202101013
  中图分类号： R619;R684;R687.406
- 收稿：2021-01-04，
  
  修回：2021-02-10，
  
  纸质出版：2021-07-15
- 稿件说明：
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吴晓光, 谢峰. 全膝关节置换术后膝关节不稳定危险因素评估[J]. 第三军医大学学报, 2021,43(13):1263-1268.

Xiaoguang WU, Feng XIE. Risk factors for knee instability after total knee arthroplasty surgery[J]. Journal of Third Military Medical University, 2021, 43(13): 1263-1268.
吴晓光, 谢峰. 全膝关节置换术后膝关节不稳定危险因素评估[J]. 第三军医大学学报, 2021,43(13):1263-1268. DOI： 10.16016/j.1000-5404.202101013.

Xiaoguang WU, Feng XIE. Risk factors for knee instability after total knee arthroplasty surgery[J]. Journal of Third Military Medical University, 2021, 43(13): 1263-1268. DOI： 10.16016/j.1000-5404.202101013.

摘要

目的

筛选并评估全膝关节置换术后膝关节不稳定的危险因素。

方法

分析2015年1月至2018年12月联勤保障部队第989医院关节脊柱科收治的136例行单侧全膝关节置换术的骨性关节炎患者的临床资料，根据手术前后是否存在膝关节不稳定进行分组，分别记录骨性关节炎疼痛评分、功能障碍评分、楼梯攀爬功率、25 m直线行走时间、膝关节屈伸范围变化情况。

结果

77.9%的患者术前即存在术侧膝关节不稳定，20.6%的患者术后关节不稳仍持续存在，术后关节持续不稳定组相较于稳定组的关节疼痛和功能障碍评分更高(7.1±3.4

3.0±2.5，18.9±11.2

8.4±8.6，

0.01)；多变量预测模型分析显示高伴随疾病评分(

6分)(

0.01)、低楼梯攀爬功率(＜150 W)(

0.01)、中-重度关节疼痛(

7分)(

0.01)及年龄因素(

60岁)(

0.01)都是术后膝关节不稳定持续存在的独立危险因素。

结论

膝关节不稳定在膝关节置换手术前后有较高的发生率，关节疼痛、功能障碍、楼梯攀爬功率与其密切相关，是潜在的可预测危险因素。

Abstract

Objective

To screen and evaluate the risk factors for knee instability after total knee arthroplasty on.

Methods

Clinical data of 136 patients who was diagnosed with knee osteoarthritis and underwent unilateral total knee arthroplasty in our department during January 2015 and December 2018 were collected and analyzed retrospectively. They were divided into knee stability and instability groups according to their conditions before and in 1 year after surgery. Knee pain and dysfunction grades of Western Ontario and McMaster Universities Arthritis Index (WOMAC)

stair-climbing power

25-meter straight-line walk time

and knee range of motion were recorded and statistically analyzed.

Results

Among the 136 cases

77.9% had preoperative knee instability

and 20.6% of them retained instability in 1 year after surgery. The subjects with retaining knee instability after surgery had significantly serious WOMAC pain and activity limitations compared to the patients without instability (7.1±3.4

3.0±2.5

18.9±11.2

8.4±8.6

0.01). Multivariate prediction model analysis predicted that comorbidity score (

6 points) (

0.01)

low stair climbing power (

150 W) (

0.01)

moderate-severe pain (

7 points) (

0.01) and older age (

60 years) (

0.01) were independent risk factors for persistent knee instability after surgery.

Conclusion

Knee instability has a high incidence before and after total knee arthroplasty and is associated with the potential risk factors of knee pain

activity limitation and stair climbing power.

关键词

Keywords

references

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张玉梅, 何洁, 黄萍, 等. 657例全膝关节置换术患者术后早期活动度对远期活动度的影响[J]. 第三军医大学学报, 2015, 37(18): 1886-1888. DOI:10.16016/j.1000-5404.201412213.

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