中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2013年
3期
234-240
,共7页
关节成形术,置换,膝%髌骨%前瞻性研究
關節成形術,置換,膝%髕骨%前瞻性研究
관절성형술,치환,슬%빈골%전첨성연구
Arthroplasty,replacement,knee%Patella%Prospective studies
目的 探讨全膝关节置换术中髌骨置换与否对早期疗效及膝前痛发生率的影响.方法 2010年6月至2011年6月拟行全膝关节置换术患者100例,随机分为两组:髌骨置换组43例50膝,髌骨未置换组57例66膝.比较术后6个月、12个月两组患者的西安大略和麦克马斯特大学(West Ontario and McMaster Universities,WOMAC)骨关节炎指数、美国膝关节外科协会(Knee Surgery Society,KSS)膝评分和功能评分、膝前痛视觉模拟评分(visual analogue scale,VAS).结果 髌骨置换组与髌骨未置换组患者术后膝前痛VAS评分均较术前明显降低,两组间VAS评分及膝前痛发生率的差异无统计学意义.WOMAC骨关节炎指数6个月分别为28.8±11.2和18.6±7.2、术后12个月分别为20.7±6.2和16.0±5.5,KSS膝评分6个月分别为(87.0±8.3)分和(90.9±7.2)分、术后12个月分别为(84.2±10.6)分和(88.8±9.2)分,KSS功能评分术后6个月分别为(86.6±21.6)分和(84.9±16.5)分、术后12个月分别为(85.2±16.4)分和(91.0±10.0)分,组间差异均无统计学意义.髌骨轴位X线片示髌骨与股骨假体滑车吻合度良好,无不稳及脱位表现.术后1年内无翻修、髌骨表面再置换病例.结论 全膝关节置换术对改善因骨关节炎或类风湿关节炎导致的膝关节疼痛、功能受限有效；髌骨置换与否对术后短期疗效及膝前痛发生率没有影响.
目的 探討全膝關節置換術中髕骨置換與否對早期療效及膝前痛髮生率的影響.方法 2010年6月至2011年6月擬行全膝關節置換術患者100例,隨機分為兩組:髕骨置換組43例50膝,髕骨未置換組57例66膝.比較術後6箇月、12箇月兩組患者的西安大略和麥剋馬斯特大學(West Ontario and McMaster Universities,WOMAC)骨關節炎指數、美國膝關節外科協會(Knee Surgery Society,KSS)膝評分和功能評分、膝前痛視覺模擬評分(visual analogue scale,VAS).結果 髕骨置換組與髕骨未置換組患者術後膝前痛VAS評分均較術前明顯降低,兩組間VAS評分及膝前痛髮生率的差異無統計學意義.WOMAC骨關節炎指數6箇月分彆為28.8±11.2和18.6±7.2、術後12箇月分彆為20.7±6.2和16.0±5.5,KSS膝評分6箇月分彆為(87.0±8.3)分和(90.9±7.2)分、術後12箇月分彆為(84.2±10.6)分和(88.8±9.2)分,KSS功能評分術後6箇月分彆為(86.6±21.6)分和(84.9±16.5)分、術後12箇月分彆為(85.2±16.4)分和(91.0±10.0)分,組間差異均無統計學意義.髕骨軸位X線片示髕骨與股骨假體滑車吻閤度良好,無不穩及脫位錶現.術後1年內無翻脩、髕骨錶麵再置換病例.結論 全膝關節置換術對改善因骨關節炎或類風濕關節炎導緻的膝關節疼痛、功能受限有效；髕骨置換與否對術後短期療效及膝前痛髮生率沒有影響.
목적 탐토전슬관절치환술중빈골치환여부대조기료효급슬전통발생솔적영향.방법 2010년6월지2011년6월의행전슬관절치환술환자100례,수궤분위량조:빈골치환조43례50슬,빈골미치환조57례66슬.비교술후6개월、12개월량조환자적서안대략화맥극마사특대학(West Ontario and McMaster Universities,WOMAC)골관절염지수、미국슬관절외과협회(Knee Surgery Society,KSS)슬평분화공능평분、슬전통시각모의평분(visual analogue scale,VAS).결과 빈골치환조여빈골미치환조환자술후슬전통VAS평분균교술전명현강저,량조간VAS평분급슬전통발생솔적차이무통계학의의.WOMAC골관절염지수6개월분별위28.8±11.2화18.6±7.2、술후12개월분별위20.7±6.2화16.0±5.5,KSS슬평분6개월분별위(87.0±8.3)분화(90.9±7.2)분、술후12개월분별위(84.2±10.6)분화(88.8±9.2)분,KSS공능평분술후6개월분별위(86.6±21.6)분화(84.9±16.5)분、술후12개월분별위(85.2±16.4)분화(91.0±10.0)분,조간차이균무통계학의의.빈골축위X선편시빈골여고골가체활차문합도량호,무불은급탈위표현.술후1년내무번수、빈골표면재치환병례.결론 전슬관절치환술대개선인골관절염혹류풍습관절염도치적슬관절동통、공능수한유효；빈골치환여부대술후단기료효급슬전통발생솔몰유영향.
Objective To evaluate the early clinic effects and anterior knee pain after total knee arthroplasty with or without patellar resurfacing.Methods From June 2010 to June 2011,100 patients who underwent TKA in our department were covered in this study,they were randomly divided two groups:resurfacing of the patellar (42 patients,50 knee) and nonresurfacing of the patellar (57 patients,66 knee).They were followed up at 6th month and 12th month.Comparison was performed with the West Ontario and McMaster Universities score (WOMAC) and Knee Surgery Society (KSS) score system,anterior knee pain visual analogue scale (VAS) score between two groups.Results Anterior knee pain VAS score had significant improvement postoperation in resurfacing groups and nonresurfacing group.But there was no statistical difference between two groups.In two groups,WOMAC scores at 6th month were 28.8±11.2 and 18.6±7.2,20.7±6.2 and 16.0±5.5 at 12th month.KSS scores at 6th month were 87.0±8.3 and 90.9±7.2,84.2±10.6 and 88.8±9.2 at 12th month.And the KSS function scores at 6th month were 86.6±21.6 and 84.9±16.5,85.2±16.4 and 91.0±10.0 at 12th month and had no statistical difference between two groups.In sunrise views (Bending 30 degrees),the curvature tolerance between patella and femoral trochlea was well at two timestamp postoperation without instability and dislocation.No revision of TKA and no re-resurfacing of patella one year after TKA.Conclusion TKA is very effective for relief of knee pain and improvement of joint function for OA and RA.Patella resurfacing and nonresurfacing have not significant difference during one year and two ways,and have the same good result in function and anterior knee pain improvement.
