双膝关节骨关节炎全膝关节置换术时间策略的研究进展

Research Progress in Time Strategy of Total Knee Arthroplasty for Osteoarthritis of Both Knees

摘要: 全膝关节置换术(total keen arthroplasty, TKA)是治疗终末期膝关节骨性关节炎(osteoarthritis, OA)最主要的方法，对于双侧膝关节OA病变的患者，TKAs可以在以下几种手术方案下完成：同期手术(一次入院一次麻醉双侧手术)、同期入院分期手术(一次入院两次麻醉两侧手术，间隔几天左右)或分期入院分期手术(两次入院两次麻醉两次手术，手术间隔几周或几个月不等)。目前国内外已经进行了一些双侧膝关节OA患者行不同手术方案TKAs治疗的对比研究，但是时间的选择上尚未达成统一。选择合适的手术方案对行双侧全膝关节置换的患者而言可以降低因双侧手术间隔时间带来的影响，包括术中及术后出血及输血情况、围术期并发症、术后功能恢复、住院费用、术后生活质量等，因此本文就上述内容的研究进展进行综述，为临床选择合适手术方案提供建议。

Abstract: Total knee arthroplasty (TKA) is the most important method for the treatment of end-stage knee joint osteoarthritis (OA). For patients with bilateral knee OA lesions, TKA can be performed under the following surgical options: simultaneous operation (one admission, one anesthetic bilateral op-eration), simultaneous admission staging operation (one admission, two anesthesia bilateral sur-gery, interval of a few days) or staging operation (two admission, two anesthesia and two operations. The interval of the operation varies from several weeks to several months). At present, some com-parative studies on TKAs treatment of bilateral knee joint OA patients have been carried out at home and abroad, but the choice of time has not been unified. Choosing an appropriate surgical scheme for patients undergoing bilateral total knee arthroplasty can reduce the impact caused by the interval between bilateral operations, including intraoperative and postoperative bleeding and blood transfusion, perioperative complications, postoperative functional recovery, hospitalization costs, postoperative quality of life, etc., so this paper reviews the research progress of the above contents and provides suggestions for the clinical selection of appropriate surgical schemes.