影响膝关节置换术术后膝前痛的相关因素

Factors related to anterior knee pain after total knee arthroplasty

目的探讨膝关节骨关节炎患者膝关节置换术(total kneearthro plasty,TKA)术后膝前痛的发生率及其相关因素。方法自2007年1月～2010年1月128例在我院初次单侧膝关节置换术的骨性关节炎患者,入院后随机分为2组,实验组64例,安装骨水泥型髌骨假体;对照组64例,仅作髌骨去神经化处理,不做髌骨置换;观察2组患者膝前痛的发生率。术前膝关节内、外翻畸形和膝关节置换术后膝前痛的关系。结果所有患者随访6～24月,平均16.5月。实验组患者膝前痛发生率10.9/%(7/64),对照组膝前痛发生率为14.1%(9/64);两组比较无显著差异。膝内、外翻畸形患者,TKA术后膝前痛的发生率为21.2%(11/52)。结论 TKA术中在置换髌骨,并不能降低膝前痛的发生率。术前膝内、外翻畸形患者术后膝前痛并发症的发生率较高。

Objective To investigate the incidence rate of anterior knee pain after total knee arthroplasty（TKA） and identify the related factors.Methods This prospective,double-blind clinical trial involved a total of 128 patients scheduled for primary ipsilateral cemented three-component TKA for osteoarthrosis.The patients were randomized into two groups to receive operations for TKA with patellar resurfacing（experimental group） or not（control）.The incidence of anterior knee pain was observed in these patients and the factor affecting the occurrence of anterior knee pain and knee was analyzed.Results The patients were followed up for a mean of 16.5 months（range 6～24 months）.The incidence rate of anterior knee pain was 10.9%（7/64） in the experimental group,showing no significant difference from the rate of 14.1%（9/64） in the control group.But the 52 patients with varus or valgus knee showed a significantly higher incidence rate of anterior knee pain（21.2%,11/52）.Conclusion TKA with patellar resurfacing can not decrease the incidence of anterior knee pain,and varus or valgus before the operation is associated with a higher risk of anterior knee pain.