全膝关节置换术中髌骨成形联合髌骨减压对早期功能及膝前痛的影响

发布时间：2018-03-08 09:49

本文选题：关节成形术　切入点：膝关节　出处：《天津医科大学学报》2016年06期 　论文类型：期刊论文

【摘要】：目的:探讨髌骨减压术与髌骨成形术对全膝关节置换术(TKA)后早期膝关节功能及膝前痛发生率的影响。方法:回顾性分析因膝关节骨关节炎行初次全膝关节置换的74例患者的病例资料,男20例,女54例;年龄48~80岁,平均(63.4±8.3)岁。依据不同手术方式将患者分为髌骨成形组(36膝)、髌骨减压组(38膝)。患者均使用相同类型的关节假体,由同一组医师完成手术。术后膝前痛采用VAS评分,髌骨功能使用Feller评分。两组患者术前一般资料、美国膝关节协会(KSS)膝评分及功能评分均无统计学差异。比较两者术后1个月、3个月、6个月、12个月的KSS膝评分、功能评分、Feller髌骨评分及术后膝前痛发生率。结果:两组KSS膝评分术后各时点的差异均无统计学意义。术后6个月、12个月的KSS功能评分和Feller髌骨评分,髌骨减压组优于髌骨成形组,差异有统计学意义。术后12个月膝前痛发生率分别为30.6%(11/36)、10.5%(4/38),两组间差异有统计学意义。结论:膝关节骨关节炎患者行保留髌骨TKA可改善膝关节功能和降低膝前痛发生率;TKA术中联合髌骨减压相比单纯髌骨成形可提高术后短期疗效,应用此技术可明显降低膝前痛发生率。
[Abstract]:Objective: to investigate the effects of patellar decompression and patelloplasty on early knee function and incidence of anterior knee pain after total knee arthroplasty. Methods: the primary total knee arthroplasty for osteoarthritis of knee joint was retrospectively analyzed. Case data of 74 patients, There were 20 males and 54 females, aged 4880 years (mean 63.4 卤8.3) years. According to the different surgical methods, the patients were divided into three groups: patellar osteoplasty group (36 knees) and patellar decompression group (38 knees). All the patients were treated with the same type of joint prosthesis. VAS score was used for anterior knee pain and Feller score for patellar function. There was no significant difference in knee score and functional score between the two groups. The KSS knee score of 1 month, 3 months, 6 months and 12 months after operation was compared between the two groups. Results: there was no significant difference between the two groups in KSS knee score at all time points after operation. The KSS functional score and Feller patellar score at 6 months and 12 months after operation were not significantly different between the two groups. The decompression group of patella was superior to the group of patellar osteoplasty. The incidence of anterior knee pain at 12 months after operation was 30.6 / 36 / 10.5, respectively. The difference between the two groups was statistically significant. Conclusion: patellar TKA can improve the function of knee joint and reduce the incidence of anterior knee pain in patients with knee osteoarthritis. TKA combined with decompression of patella can improve the short-term curative effect compared with simple patellar plasty. The application of this technique can significantly reduce the incidence of anterior knee pain.
【作者单位】：天津医科大学第四中心临床学院骨科;天津市第四中心医院骨科;
【分类号】：R687.4

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