CAJ | 학술논문

背景：全膝关节置换中是否置换髌骨以及髌骨软骨对疗效的影响还存在争议。 　　目的：评价膝关节退变性骨关节炎行保留髌骨型全膝关节置换后膝前痛发生率、临床功能及髌骨软骨退变等级对临床疗效的影响。 　　方法：回顾分析2008年6月至2010年2月采用保留髌骨型全膝关节置换治疗162例(162膝)膝关节退变性骨关节炎患者的临床资料。髌骨软骨退变等级采用 Outerbridge 分级标准、置换后膝前痛采用目测类比评分评分、临床功能采用美国膝关节学会评分和髌骨评分。 　　结果与结论：所有患者切口达Ⅰ期愈合。髌骨软骨退变等级：Ⅰ级18例；Ⅱ级36例；Ⅲ级62例；Ⅳ级35例。末次随访时，6例(4.0%)患者有膝前疼痛，其中轻度疼痛4例，中度2例，无重度疼痛。患者平均美国膝关节学会、髌骨评分均明显提高。髌骨软骨退变等级不影响置换后膝前痛发生率(χ2=0.42, P=0.94)、美国膝关节学会评分(膝评分：F=1.83，P=0.14；功能评分：F=0.56，P=0.64)和髌骨评分(F=0.78，P=0.51)。说明膝关节退变性骨性关节炎行保留髌骨型全膝关节置换可取得满意的临床疗效，髌骨软骨退变等级不影响临床疗效。
배경：전슬관절치환중시부치환빈골이급빈골연골대료효적영향환존재쟁의。 　　목적：평개슬관절퇴변성골관절염행보류빈골형전슬관절치환후슬전통발생솔、림상공능급빈골연골퇴변등급대림상료효적영향。 　　방법：회고분석2008년6월지2010년2월채용보류빈골형전슬관절치환치료162례(162슬)슬관절퇴변성골관절염환자적림상자료。빈골연골퇴변등급채용 Outerbridge 분급표준、치환후슬전통채용목측류비평분평분、림상공능채용미국슬관절학회평분화빈골평분。 　　결과여결론：소유환자절구체Ⅰ기유합。빈골연골퇴변등급：Ⅰ급18례；Ⅱ급36례；Ⅲ급62례；Ⅳ급35례。말차수방시，6례(4.0%)환자유슬전동통，기중경도동통4례，중도2례，무중도동통。환자평균미국슬관절학회、빈골평분균명현제고。빈골연골퇴변등급불영향치환후슬전통발생솔(χ2=0.42, P=0.94)、미국슬관절학회평분(슬평분：F=1.83，P=0.14；공능평분：F=0.56，P=0.64)화빈골평분(F=0.78，P=0.51)。설명슬관절퇴변성골성관절염행보류빈골형전슬관절치환가취득만의적림상료효，빈골연골퇴변등급불영향림상료효。
BACKGROUND:There remains controversy that whether patel ar resurfacing in total knee arthroplasty and whether patel ar chondromalacia has influence on clinical outcomes. OBJECTIVE:To evaluate anterior knee pain, clinical function and effects of patel ar chondromalacia on clinical outcomes after total knee arthroplasty without patel ar resurfacing for degenerative osteoarthritis. METHODS:Clinical data of 162 patients (162 knees) with degenerative osteoarthritis undergoing total knee arthroplasty without patel ar resurfacing from June 2008 to February 2010 were retrospectively analyzed. Outerbridge classification was used for patel ar chondromalacia, Visual Analogue Scale for anterior knee pain, and the Knee Society clinical scoring system for clinical function. RESULTS AND CONCLUSION:The incision of al patients reached stage-I healing. The patel ar chondromalacia:grade I in 18 patients, grade II in 36 patients, grade III in 62 patients, and grade IV in 35 patients. At the final fol ow-up, there were six (4.0%) patients with anterior knee pain, including four cases of mild pain and two cases of moderate pain, no severe pain. The mean Knee Society clinical scoring system scores and patel ar score were obviously elevated. Outerbridge classification did not affect the incidence of anterior knee pain after replacement (χ2=0.42, P=0.94), the Knee Society clinical scoring system score (knee score:F=1.83, P=0.14;functional score:F=0.56, P=0.64) and partel ar score (F=0.78, P=0.51). These data suggested that total knee arthroplasty without patel ar resurfacing for degenerative osteoarthritis can obtain satisfactory clinical outcomes, and the patel ar chondromalacia may not affect the clinical outcomes.