CAJ | 학술논문

目的评价全膝关节置换术（TKA）中髌骨翻转对术后早期膝关节功能的影响。方法纳入2008年4月至2013年9月32例双侧同期TKA患者，随机分为髌骨翻转组（A组）与髌骨侧方移位组（B组）。比较分析双膝手术时间、术后并发症、实现主动直腿抬高时间和膝关节90°屈曲时间及术后7 d、3个月、6个月、1年膝关节主动活动度、膝关节被动活动度、疼痛视觉模拟评分（VAS）。结果 A 组与B组实现主动直腿抬高的时间分别为（2．6±0．8）d和（2．1±0．6）d（P＝0．043）。除术后6个月两组膝关节被动活动度无统计学差异外，其余各随访时间点A组膝关节主动活动度、被动活动度均较B组差。两组手术时间、术后并发症、实现膝关节90°屈曲时间及VAS评分均无统计学差异。结论 TKA 中髌骨翻转不利于术后早期膝关节功能康复，可延缓患者实现直腿抬高时间，减少术后膝关节活动度。
목적평개전슬관절치환술（TKA）중빈골번전대술후조기슬관절공능적영향。방법납입2008년4월지2013년9월32례쌍측동기TKA환자，수궤분위빈골번전조（A조）여빈골측방이위조（B조）。비교분석쌍슬수술시간、술후병발증、실현주동직퇴태고시간화슬관절90°굴곡시간급술후7 d、3개월、6개월、1년슬관절주동활동도、슬관절피동활동도、동통시각모의평분（VAS）。결과 A 조여B조실현주동직퇴태고적시간분별위（2．6±0．8）d화（2．1±0．6）d（P＝0．043）。제술후6개월량조슬관절피동활동도무통계학차이외，기여각수방시간점A조슬관절주동활동도、피동활동도균교B조차。량조수술시간、술후병발증、실현슬관절90°굴곡시간급VAS평분균무통계학차이。결론 TKA 중빈골번전불리우술후조기슬관절공능강복，가연완환자실현직퇴태고시간，감소술후슬관절활동도。
Objective To assess the effect of patellar eversion in total knee arthroplasty (TKA)on the postoperative early knee function.Methods We prospectively enrolled 32 patients whose knees were treated of TKA simultaneously from April 2008 to September 2013,one knee was operated with patellar eversion (group A)and the other was operated with patellar lateral retraction (group B)randomly.The operation time,complications,the time of achieving strait leg raise (SLR)and 90°knee flexion were evaluated.Range of motion (ROM)and visual analogue scale (VAS)score were evaluated separately at seven days,three months,six months and one year postoperatively. Results The time of achieving SLR was 2 .6 ± 0 .8 d in group A and 2 .1 ± 0 .6 d in group B (P= 0 .043 ).Significant difference was found between group A and group B on active and positive ROM during the follow-up time,except the positive ROM at 6 month postoperatively.No significant difference was found on operation time,complications,the time of achieving 90°knee flexion and VAS score during the follow-up time.Conclusion Patellar eversion in TKA was adverse to the early knee function recovery,it will delay the time of achieving SLR,decreased the positive and active ROM.