髌软骨退变程度与膝骨关节炎TKA术后膝前痛相关性探究
发布时间：2018-08-29 12:14
【摘要】：目的:探讨髌骨软骨退变程度与膝骨关节炎TKA术后AKP的相关性,分析TKA术后出现AKP的原因。方法:收集2015年12月至2017年2月期间在我院骨关节外科因膝骨关节炎行全膝关节置换术的83例(102膝)患者病例资料。其中男12例(14膝),女性71例(88膝),年龄(65.8±7.6)岁。术中观察髌骨软骨退变位置,并采用Outerbridge分级标准评定髌骨软骨退变等级。将髌骨软骨整体退变IV级的患者归为A1组,将I~III级患者归为B1组;然后将髌骨软骨外侧面退变达到IV级患者归为A2组,I~III级患者归为B2组。术前及术后第1、3、6、12个月进行VAS评分并明确疼痛部位,术前及末次随访时进行KSS评分和Feller髌股关节评分。结果:全部病例得到随访,随访2~17个月,平均随访8.5个月。髌骨软骨整体退变等级:I级12膝,Ⅱ级11膝,Ⅲ级18膝,Ⅳ级61膝。髌骨软骨外侧面Ⅳ级共36膝,I~III级共66膝。A1、B1两组术后6个月和12个月膝前痛发生率、术前及术后KSS临床评分、KSS功能评分、Feller评分、VAS评分均无明显差异(P0.05)。A2、B2两组术后12个月膝前痛发生率差异有统计学意义(P0.05),术后6个月膝前痛发生率、术前及术后KSS临床评分、KSS功能评分、Feller评分、VAS评分均无明显差异(P0.05)。患者术后VAS评分、KSS临床评分、KSS临床评分、Feller评分均较术前改善,差异有统计学意义(P0.01)。结论:(1)无论髌骨软骨整体退变是否到达IV级,TKA术后膝前痛的发生率及膝关节功能无明显差异,不建议将髌骨软骨整体退变达到IV级作为髌骨置换的指标;(2)髌骨软骨外侧面退变达到IV级患者TKA术后12个月膝前痛发生率较高;(3)膝骨关节炎患者行保留髌骨型全膝关节置换术,术后功能评分和疼痛评分均较术前明显改善,短期疗效满意。
[Abstract]:Objective: to investigate the correlation between the degree of degeneration of patellar cartilage and AKP after TKA in knee osteoarthritis, and to analyze the causes of AKP after TKA. Methods: from December 2015 to February 2017, 83 patients (102 knees) with osteoarthritis underwent total knee arthroplasty in our hospital. There were 12 males (14 knees) and 71 females (88 knees) aged (65.8 卤7.6) years. The degenerative position of patellar cartilage was observed during operation and the grade of degeneration of patellar cartilage was evaluated by Outerbridge grading standard. The patients with global degeneration of patellar cartilage in IV grade were classified into A1 group, I~III grade group was classified into B1 group, and the patients with lateral degeneration of patellar cartilage to IV grade were classified as A2 group and B2 group. VAS score and pain location were evaluated at 12 months and KSS score and Feller patellofemoral joint score were performed before and at the last follow-up. Results: all the patients were followed up for 2 ~ 17 months with an average of 8.5 months. The total degeneration grade of patella cartilage was 12 knees in grade I, 11 knees in grade 鈪，
本文编号：2211173
[Abstract]:Objective: to investigate the correlation between the degree of degeneration of patellar cartilage and AKP after TKA in knee osteoarthritis, and to analyze the causes of AKP after TKA. Methods: from December 2015 to February 2017, 83 patients (102 knees) with osteoarthritis underwent total knee arthroplasty in our hospital. There were 12 males (14 knees) and 71 females (88 knees) aged (65.8 卤7.6) years. The degenerative position of patellar cartilage was observed during operation and the grade of degeneration of patellar cartilage was evaluated by Outerbridge grading standard. The patients with global degeneration of patellar cartilage in IV grade were classified into A1 group, I~III grade group was classified into B1 group, and the patients with lateral degeneration of patellar cartilage to IV grade were classified as A2 group and B2 group. VAS score and pain location were evaluated at 12 months and KSS score and Feller patellofemoral joint score were performed before and at the last follow-up. Results: all the patients were followed up for 2 ~ 17 months with an average of 8.5 months. The total degeneration grade of patella cartilage was 12 knees in grade I, 11 knees in grade 鈪，
本文编号：2211173
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