全膝关节置换术治疗伴有高位髌骨的重度骨性关节炎

摘要

目的 研究全膝关节置换术(total knee arthroplasty,TKA)治疗伴有高位髌骨的重度骨性关节炎的治疗效果.方法 伴有高位髌骨的重度骨性关节炎病人13例,行全膝关节置换术治疗,术中通过改变胫骨平台线的高度来调整髌骨的相对位置,测量手术前后髌骨关节面最下点至胫骨平台线的垂线长度,计算其与髌骨关节面长度的比值,即Blackburne-Peel(BP)指数,并在术前及术后3个月采用美国特种外科医院膝关节评分系统(HSS)进行评分.结果 13例病人均获得随访,切口均一期愈合,无其他并发症,术前与术后BP指数及HSS评分比较,差异有统计学意义(P<0.05).结论 通过调整髌骨相对高度,纠正下肢力线,全膝关节置换术能够治疗伴有高位髌骨的重度骨性关节炎,改善膝关节功能.%Objective To study the therapeutic effect of total knee arthroplasty(TKA)in treat-ment of severe osteoarthritis with patella alta.Methods TKA was performed on 13 patients of severe os-teoarthritis with patella alta,to adjust the relative position of the patella by changing the height of the plat-form line in the operation,and measure the length of the perpendicular line from the lowest point of the pa-tella joint surface to the tibial platform line before and after knee replacement,calculate and compare the ratio of the length to the joint surface of the patella(BP index).In addition,the score of the knee joint was evaluated by American special surgery hospital knee joint scoring system(HSS)at preoperative and post-operative three months.Results All the patients'incision got primary healing who were followed up with-out other complications.The BP index and the HSS score was statistically significant before and after sur-gery(P<0.05).Conclusion Total knee arthroplasty can be used to treat severe osteoarthritis with high patella by adjusting the relative height of the patella and correcting the limb alignment,to improve the function of knee joint and the quality of life.