人工膝关节置换髌骨处理的对比分析

Comparative Analysis of Patella Treatment in TKA

目的总结髁型人工膝关节置换髌骨处理原则。方法通过回顾性分析，对比人工膝关节置换术髌骨成形组与髌骨置换组间的临床效果差别。结果36例（47膝）行髌骨成形术，20例（24膝）行髌骨置换术。随访18～60个月，平均48．8个月，两组患者的HSS评分、屈膝角度以及髌前疼痛情况无差别。结论在目前的技术水平条件下，对形态和运动轨迹都良好的髌骨，仅行髌骨成形术可取得良好临床效果。对行髌骨置换的患者，正确的假体安放以及各部件之间的良好匹配是取得良好效果的关键。

Objective To summarize the dealing principle of patella in TKA. Methods The clinical results between the TKA with patella replacement and the TKA with unreplaced patella were retrospectively compared. Results Thirty - six cases （47 knees） with unreplaced patella, 20 cases （24 knees） with replaced patella were included. The follow- up period ranged from 18 to 60 months, averaged 48.8 months. Based on P 〈 0.05, there was no difference in HSS, knee reflexion and peri- patella pain between the two groups. Conclusion It is possible to get the good result in total condylar knee arthropiasty without patella replacement if the patella is in good morphologic and tracking condition. It is the key points to place the implant properly and to make the implants fit congruently between the different parts.