目的总结膝关节屈曲挛缩畸形患者行全膝关节置换术的围术期护理经验。方法回顾性分析本院2004年1月-2009年6月104例膝关节屈曲畸形行全膝关节置换术患者的临床资料,并总结护理要点。结果术后93例患者膝关节的屈曲畸形得以完全矫正,11例...目的总结膝关节屈曲挛缩畸形患者行全膝关节置换术的围术期护理经验。方法回顾性分析本院2004年1月-2009年6月104例膝关节屈曲畸形行全膝关节置换术患者的临床资料,并总结护理要点。结果术后93例患者膝关节的屈曲畸形得以完全矫正,11例残留5-15°的屈曲。术后中位美国膝关节协会评分(knee society score,KSS)80.65分,中位膝关节功能评分83.68分,均较术前明显提高;所有患者术后无出现并发症。结论术前做好心理护理,正确指导早期功能锻炼;术后严密观察生命体征,选择正确体位,预防护理并发症;同时加强功能锻炼,以促进患者早日康复。展开更多
AIM: To quantify and reduce the errors in visual estimation of knee flexion contractures during total knee arthroplasty(TKA).METHODS: This study was divided into two parts: Quantification of error and reduction of err...AIM: To quantify and reduce the errors in visual estimation of knee flexion contractures during total knee arthroplasty(TKA).METHODS: This study was divided into two parts: Quantification of error and reduction of error. To quantify error, 3 orthopedic surgeons visually estimated preoperative knee flexion contractures from lateral digital images of 23 patients prior to and after surgical draping. A repeated-measure analysis of variance was used to compare the estimated angles prior to and following the placement of the surgical drapes with the true knee angle measured with a long-arm goniometer. In an effort to reduce the error of visual estimation, a dual set of inclinometers was developed to improve intraoperative measurement of knee flexion contracture during TKA. A single surgeon performed 6 knee extension measurements with the device during 146 consecutive TKA cases. Three measurements were taken with the desired tibial liner trial thickness, and 3 were taken with a trial that was 2 mm thicker. An intraclass correlation coefficient(ICC) was calculated to assess the testretest reliability for the 3 measurements taken with the desired liner thickness, and a paired t test was used to determine if the knee extension measurements differed when a thicker tibial trial liner was placed.RESULTS: The surgeons significantly overestimated flexion contractures in 23 TKAs prior to draping and significantly underestimated the contractures after draping(actual knee angle = 6.1°± 6.4°, pre-drape estimate = 6.9°± 6.8°, post-drape estimate = 4.3°± 6.1°, P = 0.003). Following the development and application of the measurement devices, the measurements were highly reliable(ICC = 0.98), and the device indicated that 2.7°± 2.2° of knee extension was lost with the insertion of a 2 mm thicker tibial liner. The device failed to detect a difference in knee extension angle with the insertion of the 2 mm thicker liner in 9/146 cases(6.2%).CONCLUSION: We determined the amount of error associated with visual estimation of knee展开更多
文摘目的总结膝关节屈曲挛缩畸形患者行全膝关节置换术的围术期护理经验。方法回顾性分析本院2004年1月-2009年6月104例膝关节屈曲畸形行全膝关节置换术患者的临床资料,并总结护理要点。结果术后93例患者膝关节的屈曲畸形得以完全矫正,11例残留5-15°的屈曲。术后中位美国膝关节协会评分(knee society score,KSS)80.65分,中位膝关节功能评分83.68分,均较术前明显提高;所有患者术后无出现并发症。结论术前做好心理护理,正确指导早期功能锻炼;术后严密观察生命体征,选择正确体位,预防护理并发症;同时加强功能锻炼,以促进患者早日康复。
文摘AIM: To quantify and reduce the errors in visual estimation of knee flexion contractures during total knee arthroplasty(TKA).METHODS: This study was divided into two parts: Quantification of error and reduction of error. To quantify error, 3 orthopedic surgeons visually estimated preoperative knee flexion contractures from lateral digital images of 23 patients prior to and after surgical draping. A repeated-measure analysis of variance was used to compare the estimated angles prior to and following the placement of the surgical drapes with the true knee angle measured with a long-arm goniometer. In an effort to reduce the error of visual estimation, a dual set of inclinometers was developed to improve intraoperative measurement of knee flexion contracture during TKA. A single surgeon performed 6 knee extension measurements with the device during 146 consecutive TKA cases. Three measurements were taken with the desired tibial liner trial thickness, and 3 were taken with a trial that was 2 mm thicker. An intraclass correlation coefficient(ICC) was calculated to assess the testretest reliability for the 3 measurements taken with the desired liner thickness, and a paired t test was used to determine if the knee extension measurements differed when a thicker tibial trial liner was placed.RESULTS: The surgeons significantly overestimated flexion contractures in 23 TKAs prior to draping and significantly underestimated the contractures after draping(actual knee angle = 6.1°± 6.4°, pre-drape estimate = 6.9°± 6.8°, post-drape estimate = 4.3°± 6.1°, P = 0.003). Following the development and application of the measurement devices, the measurements were highly reliable(ICC = 0.98), and the device indicated that 2.7°± 2.2° of knee extension was lost with the insertion of a 2 mm thicker tibial liner. The device failed to detect a difference in knee extension angle with the insertion of the 2 mm thicker liner in 9/146 cases(6.2%).CONCLUSION: We determined the amount of error associated with visual estimation of knee
