- TKA是否需要置换髌骨
- 作者:刘忠堂|发布时间:2011-11-16|浏览量:606次
全膝关节置换术中髌骨面修整与髌骨
置换的比较研究
刘忠堂 吴宇黎李晓华钱齐荣祝云利 吴海山
? 1087 ?
. 人工关节置换?上海市第六人民医院骨科刘忠堂
【摘要】 目的 比较全膝关节置换术髌骨面修整和髌骨置换的临床结果。方法2002年1月
至12月对6o例(60膝)行初次全膝关节置换术的骨性关节炎患者进行前瞻性、随机化研究。所有患
者接受相同的后交叉韧带替代型全膝关节假体(PFC),患者随机行髌骨面修整(髌骨面修整组)或髌
骨置换(髌骨置换组)。58例患者平均随访54个月(加~6o个月),对其进行临床评价,包括膝关节
协会评分(KSS)、膝关节活动度(ROM)、患者满意度和x线检查。结果两组患者KSS总评分(P=
0.12)、KSS疼痛评分(P:0.90)、患者满意度(P=0.22)无明显差异;两组术后膝前痛的发生率均为
10%亦无明显差异。两组ROM(P=0.028)和KSS功能评分(P=0.0098)差异有统计学意义。结论
全膝关节置换术不论是髌骨面修整还是髌骨置换均能明显减轻疼痛和改善功能。术后膝前痛可能与
假体设计和手术技术有关,并非与是否置换髌骨有关。
【关键词】关节成形术,置换,膝; 髌骨; 修整; 前瞻性研究; 随机对照试验
Patella reshaping versIis resurfacing in total knee arthroplasty:a prospective randomized study HU
Zhong-tang ,WU Yu一如,LI Xiao-hua, .7、『Qi-rong,ZHU Yun-li,WU Hai-shah. Departme~ of
Orthopedics,Changzheng Ho~ital,the Second Military Medical University,Shanghai 200003,China
Corresponding author:WU Yu.1i.Email:wuyuli@ i33sh.corn
【Abstract】 objective To investigate the diferences in tlle clinical outcome of total knee
arthroplasty according to patelar reshaping or resurfacing.M ethods From January 2002 to December 2002,
60 patients(60 knees)undergoing primary total knee arthroplasty for the treatment of osteoarthritis were
enrolled in a prospective,randomized study.All patients received the sanle posterior-erueiated?substituting
total knee prosthetic compo nents.Patients were randomized to the treatment tll reshaping or resurfaeing of
the patela,and the results were folowed up f0r a mean of 54 months(40-60 months). Evaluations
consisted of the determination of a Knee Society Score,range of motion for knees。patient satisfaction,and
radiographs.Results Witll the numbers available for study.no significant diference was found between the
knees that had patelar resurfacing and those that had patelar reshaping witll regard to the overall scoref P=
0.12),the subscore for pain(P=0.90),and patient satisfaction(P=0.22).The results showed that the
s砌e prevalence of any anterior kne pain in two groups Was 10% .and it did not represent a significant
difefence.The two groups showed statistical diference with regard to the total function score and range of
motion.Conclusions It has shown that total knee arthroplasty with patela reshaping or resurfacing
dramatically relieves pain an d improves the fun ction.It seems that postoperative anterior knee pain iS related
either to the component design or to the details of the surgical technique,rather than to whether or not the
patela is resurfaced.
【Key words】 Anhroplasty,replacement,knee; Patela; Reshaping; Prospective study;
Randomized controled trial
置换的比较研究
刘忠堂 吴宇黎李晓华钱齐荣祝云利 吴海山
? 1087 ?
. 人工关节置换?上海市第六人民医院骨科刘忠堂
【摘要】 目的 比较全膝关节置换术髌骨面修整和髌骨置换的临床结果。方法2002年1月
至12月对6o例(60膝)行初次全膝关节置换术的骨性关节炎患者进行前瞻性、随机化研究。所有患
者接受相同的后交叉韧带替代型全膝关节假体(PFC),患者随机行髌骨面修整(髌骨面修整组)或髌
骨置换(髌骨置换组)。58例患者平均随访54个月(加~6o个月),对其进行临床评价,包括膝关节
协会评分(KSS)、膝关节活动度(ROM)、患者满意度和x线检查。结果两组患者KSS总评分(P=
0.12)、KSS疼痛评分(P:0.90)、患者满意度(P=0.22)无明显差异;两组术后膝前痛的发生率均为
10%亦无明显差异。两组ROM(P=0.028)和KSS功能评分(P=0.0098)差异有统计学意义。结论
全膝关节置换术不论是髌骨面修整还是髌骨置换均能明显减轻疼痛和改善功能。术后膝前痛可能与
假体设计和手术技术有关,并非与是否置换髌骨有关。
【关键词】关节成形术,置换,膝; 髌骨; 修整; 前瞻性研究; 随机对照试验
Patella reshaping versIis resurfacing in total knee arthroplasty:a prospective randomized study HU
Zhong-tang ,WU Yu一如,LI Xiao-hua, .7、『Qi-rong,ZHU Yun-li,WU Hai-shah. Departme~ of
Orthopedics,Changzheng Ho~ital,the Second Military Medical University,Shanghai 200003,China
Corresponding author:WU Yu.1i.Email:wuyuli@ i33sh.corn
【Abstract】 objective To investigate the diferences in tlle clinical outcome of total knee
arthroplasty according to patelar reshaping or resurfacing.M ethods From January 2002 to December 2002,
60 patients(60 knees)undergoing primary total knee arthroplasty for the treatment of osteoarthritis were
enrolled in a prospective,randomized study.All patients received the sanle posterior-erueiated?substituting
total knee prosthetic compo nents.Patients were randomized to the treatment tll reshaping or resurfaeing of
the patela,and the results were folowed up f0r a mean of 54 months(40-60 months). Evaluations
consisted of the determination of a Knee Society Score,range of motion for knees。patient satisfaction,and
radiographs.Results Witll the numbers available for study.no significant diference was found between the
knees that had patelar resurfacing and those that had patelar reshaping witll regard to the overall scoref P=
0.12),the subscore for pain(P=0.90),and patient satisfaction(P=0.22).The results showed that the
s砌e prevalence of any anterior kne pain in two groups Was 10% .and it did not represent a significant
difefence.The two groups showed statistical diference with regard to the total function score and range of
motion.Conclusions It has shown that total knee arthroplasty with patela reshaping or resurfacing
dramatically relieves pain an d improves the fun ction.It seems that postoperative anterior knee pain iS related
either to the component design or to the details of the surgical technique,rather than to whether or not the
patela is resurfaced.
【Key words】 Anhroplasty,replacement,knee; Patela; Reshaping; Prospective study;
Randomized controled trial