Objective To investigate the effects of total knee arthroplasty combined with compound release on the joint space,knee joint mobility and HSS score of patients with severe osteoarthritis. Methods One hundred and twelve patients with severe osteoarthritis were randomly divided into standard prosthesis group and compound release group,with 56 patients in each group.The patients in standard prosthesis group were treated by knee arthroplasty,however,the patients in compound release group,on the basis of standard prosthesis group,were treated by knee joint compound release operation. The knee joint HSS scores including pain,function, activity,muscle strength,flexion deformity,stability and total score were observed after surgery,moreover,the knee extension gap,knee flexion gap,time of knee flexion 90°,time of knee flexion 120° were observed and compared between two groups. Moreover the postoperative effects including tibial angle before and after surgery,the maximum genuflex angle,squatting and fricative frequency were evaluated by means of Lysholm knee score. Results The knee extension gap in compound release group was significantly greater than that in standard prosthesis group, however,the time of knee flexion 90° and time of knee flexion 120° in compound release group were significantly shorter than those in standard prosthesis group (P<0.05). Moreover there was no significant difference in knee flexion gap between two groups (P>0.05). The pain,function, activity,muscle strength,flexion deformity,stability and total scores in compound release group were significantly higher than those in standard prosthesis group(P<0.05).After operation the tibial angle was less than that before treatment in both groups,however, the maximum genuflex angle was larger than that before treatment (P<0.05).However there were no significant differences in tibial angle and maximum genuflex angle after operation between the two groups (P>0.05).Besides the incidence rate of fricatives in compound release group was significantly lower than that in standard prosthesis group (P<0.05),and the squating rate was higher than that in standard prosthesis group,however, there was no significant difference between two groups ( P> 0.05). Finally, the therapeutic effects and excellent rate in compound release group were superior to those in standard prosthesis group ( P<0.05). Conclusion The total knee arthroplasty combined with compound release can significantly improve the pathological status and function of knee joint of patients with severe osteoarthritis,which can relieve knee joint pain,increase the activity and improve life quality of patients.%目的 研究标准假体全膝关节置换术联合复合松解治疗严重骨性关节炎对患者关节间隙、膝关节活动度、HSS评分的影响.方法 112例严重骨性关节炎患者随机分为标准假体组和复合松解组,每组56例.标准假体组采用膝关节置换术,复合松解组在膝关节置换术基础上针对不同情况采用对应的膝关节复合松解术.观察手术情况(伸膝间隙、屈膝间隙、主动屈膝90°时间、主动屈膝120°时间)、膝关节HSS评分(疼痛、功能、活动度、肌力、屈曲畸形、稳定性、总分)、术后效果(手术前后胫骨角、最大屈膝角度、能够下蹲、摩擦音发生率),并采用Lysholm 膝关节评分进行效果评价.结果 复合松解组伸膝间隙大于标准假体组,主动屈膝90°时间、主动屈膝120°时间短于标准假体组,差异有统计学意义(P<0.05).2组屈膝间隙比较差异无统计学意义(P>0.05).复合松解组疼痛、功能、活动度、肌力、屈曲畸形、稳定性和总分均高于标准假体组,差异有统计学意义(P<0.05).2组术后胫骨角小于治疗前,最大屈膝角度大于治疗前,差异有统计学意义(P<0.05),2组术后胫骨角和最大屈膝角度比较,差异无统计学意义(P>0.05).复合松解组摩擦音发生率低于标准假体组,差异有统计学意义(P<0.05),下蹲率高于标准假体组,但差异无统计学意义(P>0.05).复合松解组疗效、优良率均优于标准假体组,差异有统计学意义(P<0.05).结论 标准假体全膝关节置换术联合复合松解可以显著改善患者膝关节病理状态和功能,减轻患者膝关节疼痛,增强其活动度,提高患者生活质量.
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