同期双侧全膝关节表面置换中行髌骨置换修复膝关节骨性关节炎

摘要

背景:人工全膝关节置换是目前治疗各类终末期或重症膝关节病变最有效、最成功的治疗方法之一,但目前对于全膝关节置换中是否常规行髌骨置换尚未达成一致意见.目的:探讨同期行双侧膝关节表面置换时同时行髌骨置换对治疗膝关节骨性关节炎的疗效分析.方法:选择2013年2月至2014年2月青岛大学附属医院关节外科收治的膝骨性关节炎行双侧膝关节置换患者机分为2组,置换组术中行髌骨置换,非置换组未置换髌骨.结果与结论:置换后3,6,12个月,两组患者膝关节功能评分及膝关节活动度差异均无显著性意义(P＞0.05).患者出现膝前痛共 12 例,其中置换组 4(13％)例,未置换组 8(27％)例.无假体断裂、松动、移位等、髌骨骨折、髌骨坏死等并发症,亦无髌骨假体翻修情况.结果证实,同期双侧全膝关节置换行髌骨置换与不置换具有相同的短期疗效.%BACKGROUND: Total knee arthroplasty is one of the most effective and successful operations for the treatment of various end-stage or severe knee diseases.However,there is no consensus about routine patela resurfacing in total knee arthroplasty.OBJECTIVE:To investigate the efficacy of patelar arthroplasty in one-stage bilateral total knee arthroplasty for the treatment of knee osteoarthritis.METHODS:Patients undergoing bilateral total knee arthroplasty were selected from the Department of Orthopedic Surgery,Affiliated Hospital of Qingdao University in China between February 2013 and February 2014.They were randomly assigned to two groups.Patelar resurfacing group received patelar arthroplasty.Non-patelar resurfacing group did not receive patelar arthroplasty.RESULTS AND CONCLUSION:At 3,6 and 12 months folowing the surgery,no significant difference in Knee Society Score and range of motion of knee joint was detected between the two groups (P＞0.05).12 cases experienced anterior knee pain,including 4(13％) of the patelar resurfacing group and 8(27％) of the non-patelar resurfacing group.There were no complications such as prosthesis fracture,loosening,displacement,patelar fracture or patelar necrosis,and patelar prosthesis revision.Results verified that patelar arthroplasty and non-patelar arthroplasty have the same short-term effectiveness in one-stage bilateral total knee arthroplasty for osteoarthritis.