CAJ | 학술논문

目的探讨全膝关节置换术后膝关节线改变与膝前痛的相关性.方法回顾性分析2008年1月至2010年12月因膝关节骨关节炎行初次全膝关节置换的76例患者的病例资料,男11例,女65例；年龄47～83岁,平均(68.88±7.61)岁.术中应用PFC后稳定型固定平台膝关节假体.术后每12个月定期门诊随访一次.根据Figgie膝关节线测量方法对术前及随访时的关节线进行测量,并计算术前、术后关节线的变化.关节线升高为正值,关节线降低为负值.采用Feller评分法评估术前及随访时的髌骨功能.评估术后24个月的关节线改变水平与Feller髌骨评分的相关性.结果关节线改变-6.8～10.44 mm,平均(2.69±3.31) mm.随膝关节线升高,Feller髌骨评分呈下降趋势；关节线改变值与Feller髌骨评分呈负相关(r=-0.763,P=0.000).随关节线降低,Feller髌骨评分呈下降趋势；关节线改变值与髌骨评分呈正相关(r=0.914,P=0.000).术后12、24个月关节线改变4 mm以内的患者(55例)Feller髌骨评分均高于关节线改变大于4 mm的患者(21例),差异有统计学意义(t=12.648,P=0.000；t=11.775,P=0.000).结论对后稳定型固定平台膝关节假体,关节线改变与膝前痛具有相关性,保持关节线变化在±4 mm以内有利于恢复膝关节功能.
목적 탐토전슬관절치환술후슬관절선개변여슬전통적상관성.방법 회고성분석2008년1월지2010년12월인슬관절골관절염행초차전슬관절치환적76례환자적병례자료,남11례,녀65례；년령47～83세,평균(68.88±7.61)세.술중응용PFC후은정형고정평태슬관절가체.술후매12개월정기문진수방일차.근거Figgie슬관절선측량방법대술전급수방시적관절선진행측량,병계산술전、술후관절선적변화.관절선승고위정치,관절선강저위부치.채용Feller평분법평고술전급수방시적빈골공능.평고술후24개월적관절선개변수평여Feller빈골평분적상관성.결과 관절선개변-6.8～10.44 mm,평균(2.69±3.31) mm.수슬관절선승고,Feller빈골평분정하강추세；관절선개변치여Feller빈골평분정부상관(r=-0.763,P=0.000).수관절선강저,Feller빈골평분정하강추세；관절선개변치여빈골평분정정상관(r=0.914,P=0.000).술후12、24개월관절선개변4 mm이내적환자(55례)Feller빈골평분균고우관절선개변대우4 mm적환자(21례),차이유통계학의의(t=12.648,P=0.000；t=11.775,P=0.000).결론 대후은정형고정평태슬관절가체,관절선개변여슬전통구유상관성,보지관절선변화재±4 mm이내유리우회복슬관절공능.
Objective To investigate the correlation between knee joint line and anterior knee pain after total knee arthroplasty (TKA).Methods From January 2008 to December 2010,76 patients with osteoarthritis underwent primary TKA in our hospital,including 11 males and 65 females,aged from 47 to 83 years (average,68.88±7.61 years).Fixed-bearing posterior stabilized TKA (PFC) was used in all patients.All patients were followed up every 12 months after TKA.According to the Figgie's method,pre-and post-operative knee joint line was measured,and the changes of pre-and post-operative knee joint line were calculated.If the knee joint line was elevated,it was defined as positive; on the contrary,it was defined as negative.The Feller's patellar score was used to assess pre-and post-operative patellar function.The correlation between joint line level and Feller's patellar score was analyzed 24 months after operation.Results The joint line level ranged from-6.8 to 10.44 mm (average,2.69±3.31 mm).With the rise of the joint line,the patient's patella score decreased.There is a negative correlation between the elevated joint line level and Feller's patellar score (r=-0.763,P=0.000).The Feller's patellar score decreased with the fall of joint line level,and there is a positive correlation between them (r=0.914,P=0.000).The Feller's patellar score was higher in patients whose joint line change was less than 4 mm than that in patients whose joint line change was greater than 4 mm (t=12.648,P=0.000; t=l 1.775,P=0.000).Conclusion The joint line change was correlated to anterior knee pain after TKA with fixedbearing posterior stabilized prosthesis.The joint line change less than 4 mm can result in a better knee joint function.