髌骨钻孔减压改善全膝关节置换术后膝前疼痛

摘要

目的：探讨通过髌骨钻孔减压术改善全膝关节置换术（TKA ）后膝前痛的临床疗效。方法将符合标准的113例行TKA的骨关节炎患者按数字法随机分为两组：54例为减压组，TKA术中联合髌骨钻孔减压术；59例为非减压组，仅施行TKA不联合髌骨钻孔减压术。术后观察两组患者切口愈合情况、相关并发症、KSS评分及膝前痛发生率。结果两组患者切口均一期愈合，无严重并发症发生，113例均获满12个月的完整随访。KS S评分：减压组术后明显高于非减压组；术后膝前痛的发生率明显低于非减压组，差异均有统计学意义（P＜0.05）。结论 TKA术中联合髌骨减压术可以在一定程度上改善膝关节KSS评分及降低术后膝前疼痛的发生率。%Objective To evaluated the efficacy of patellar decompression via drilling for the treatment of anterior knee pain following total knee arthroplasty(TKA).Methods 1 13 knees with osteoarthritis who met the selection cri-teria underwent artificial TKA were randomly divided into two groups using digital method:54 patients who underwent primary TKA with patellar decompression (decompression group),59 patients who underwent primary TKA with pa-tellar decompression without decompression (non-decompression group).Incision healing,related complications,KSS score and anterior knee pain of postoperative were observed.Results The two groups of patients got postoperative wound healing of stageⅠ.No serious complications were found.All cases got complete follow-up for 12 months.KSS score of patients with patellar decompression after patellar decompression (decompression group)was significantly higher than patients without patellar decompression (non-decompression group),and the postoperative anterior knee pain was significantly lower than non-decompression group.The differences had statistical significance (P<0.05 ). Conclusions Patellar decompression without patellar resurfacing could improve KSS score,and reduce the rate of postoperative anterior knee pain in cases of total knee replacement.