全膝關節置換手術後病患的膝功能評估

Functional Evaluation of the Knees in the Patients after Total Knee Replacement

薛澤杰(Rou-Zin Shai) ； 曹昭懿(Jau-Yih Tsauo) ； 賴金鑫(Jin-Shin Lai) ； 連倚南(I-Nan Lien)

《中華民國復健醫學會雜誌》 16期 (1988/12) Pp. 60-66

摘要

全膝關節置換在嚴重膝關節障礙的治療上漸居重要地位。為了解全膝關節置換後病患之膝功能變化情形及評估其療效，本研究乃以民國75年1月至9月在台大醫院骨科接受全膝關節置換手術的病患為對象，作手術前及術後三、六、十二個月的膝功能評估，以便追蹤比較。
由可追蹤到術後六個月的11位及十二個月的5位病患中發現，全膝關節置換對膝關節嚴重損傷之患者確實有很大的幫助；尤其是對疼痛的減輕是所有病患共同的體認。一般膝功能的恢復在術後六個月可達穩定狀態，其後雖然功能仍隨時間而有進步，但其進步之幅度不大。
膝關節活動度的減少，術後三個月平均喪失30度，對日常生活的屈膝動作，蹲及站立有不方便的影響。日後雖然有進步，但尚無能達完全活動度的病例。
兩側肌力不論是伸肌或屈肌在術前都有顯著差異，在術後三個月時，雨側伸肌差異依然明顯，但患側屈肌已有進步；到術後六個月兩側肌力差異就逐漸減小。

並列摘要

The Total Knee Replacement (TKR) is getting more important for management of severe knee joint disorder. In order to understand the changes of knee function after TKR and evaluate the benefits for patient, this research was designed to compare them before operation, three months, six months and twelve months after operation who received TKR operation at Orthopedic Department of National Taiwan University Hospital from Jan to Sep 1986.
According to the assessment of 11 patients who were traced for six months and five patients who were traced for twelve months, it indicated that TKR was definitely helpful for those patients with severe knee damage, especially in pain relief, which was recognized by all the patients. Generally, recovery of knee function after TKR will reach its stable situation in six months after operation. After six months, the knee function will be still improving, but not much.
The range of motion loss of knee joint was 30 degrees averagely in three months after operation and it always affects the knee flexion, squatting and standing during
activity of daily living. There was no case reaching the full range of motion of knee, even the progress continued three months after operation.
The muscle strength of involved knee flexors and extensors had significant difference compared to sound side before operation and it remained the same at knee extensors three months after operation but some progress
could be noticed at knee flexors. Those difference will be decreased six months after operation.

並列關鍵字

total knee replacement