髌骨周围电灼去神经化对TKA后患者膝前痛及膝关节功能的影响

发布时间：2018-04-29 20:48

本文选题：膝关节置换 + 膝前痛　；参考：《山东医药》2017年48期

【摘要】：目的探讨髌骨周围电灼去神经化对全膝关节置换术(TKA)后患者膝前痛及膝关节功能的影响。方法选取行单侧TKA治疗的重度膝骨关节炎患者64例(64膝),随机分为去神经组和未去神经组,每组32例(32膝)。两组术中均不行髌骨置换。去神经组术中行髌骨周围电灼去神经化处理。统计手术时间,计算累积总引流量;术前、术后6周和术后3、6、12个月时分别进行美国膝关节外科协会(KSS)膝和膝功能评分、Feller髌骨和功能评分、膝关节活动度(ROM)检测及疼痛视觉模拟(VAS)评分。结果两组手术均成功,两组手术时间及累积总引流量比较P均0.05。两组术后6周和术后3、6、12个月时KSS膝及膝功能评分、Feller髌骨及髌骨功能评分、ROM均高于术前,VAS评分均低于术前;去神经组术后3、6、12个月时KSS膝及膝功能评分、VAS评分均高于未去神经组,ROM低于未去神经组;去神经组术后6、12个月时Feller髌骨评分均高于未去神经组;组间及组内比较P均0.05。术后12个月时,去神经组膝关节功能优良率高于未去神经组(P0.05);膝前痛发生率低于未去神经组(P0.05)。结论髌骨周围电灼去神经化处理可降低TKA后膝前痛程度及发生率,并促进膝关节功能恢复。
[Abstract]:Objective to investigate the effect of peripatellar electrocautery on anterior knee pain and knee function after total knee arthroplasty (TKA). Methods 64 patients with severe knee osteoarthritis treated with unilateral TKA were randomly divided into denervated group (n = 32) and non-denervated group (n = 32). Patella replacement was not performed in both groups. In the denervated group, peripatellar electrocautery was performed. Before operation, 6 weeks after operation, 6 weeks after operation, 6 months after operation and 12 months after operation, the knee and knee function score (Feller patella and function score) of the American Association of knee Surgeons (AKS) were evaluated, respectively. Knee motion was measured and visual analogue pain was assessed. Results the operation time and cumulative total drainage in both groups were all successful (P 0.05). KSS knee and knee function scores in both groups were higher than those before operation at 6 weeks after operation and 6 months after operation, and at 12 months, the scores of Feller patella and patella function were lower than those before operation. In the denervated group, the KSS knee and knee function scores were significantly higher than those in the non-denervated group at 3 and 12 months after operation, and the Feller patella score in the denervated group was higher than that in the non-denervated group at 6 and 12 months after operation (P < 0.05). At 12 months after operation, the excellent and good rate of knee joint function in the denervated group was higher than that in the non-denervated group, and the incidence of anterior knee pain was lower than that in the non-denervated group. Conclusion Peripatellar electrocauterization can reduce the degree and incidence of anterior knee pain after TKA and promote the recovery of knee function.
【作者单位】：天津医科大学第四中心临床学院;武警后勤学院附属医院骨科医院;
【基金】：天津市卫生行业重点攻关项目(15kg122)
【分类号】：R687.4

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