髌骨切除病人的全膝关节置换术

Total knee arthroplasty after patellectomy

目的 :对髌骨切除病人的全膝关节置换术的效果进行评估。方法 :将 9例髌骨切除术后病人的TKA手术效果和正常病人的TKA手术效果对比。结果 :髌骨切除组的 7例病人疼痛完全缓解 ,另 2例病人仍有持续性疼痛。对照组病人的疼痛全部缓解。髌骨切除组病人的平均术前活动度是 78° ,术后为 90°。其中的 2例病人分别因为无菌性胫骨部件松动和感染而接受翻修术。对照组病人的平均术前活动度为 82° ,术后为 83°。对照组没有一个病人出现并发症。结论 :尽管髌骨切除术后的TKA病人有多种并发症 ,但是这一手术的结果还是可以接受的。

Objective:To evaluate the results of total knee arthroplasty after patellectomy.Method:Compared the outcome of total knee arthroplasty in 9 patients who had previous patellectomy with the results in a matched series of arthroplasties performed on knees in which the patella was intact.Result:Pain was completely relieved in 7 patients in the study group but persisted in two.In the control group,pain was relieved in all 9 patients.The mean preoperative arc of movement in the study group was 78°;postoperatively,it was 90°.The mean preoperative arc of movement in the control group was 82°;postoperatively,it was 83 °.Two patients have required revision,one for aseptic tibial loosening and the other for infection.There were no complications in the control group.Conclusion:Although the patients who had knee arthroplasty after prior patellectomy has more complications and a generally less successful outcome than did those with an intact patella,the results are,nevertheless,good enough for us to continue to recommend the operation in this special group of patients.