髌下脂肪垫对全膝关节置换术后髌骨高度的影响

The effects of intrapatellar fat pad on the patellar height after TKA

目的:研究保留或切除髌下脂肪垫对全膝关节置换术(total knee arthroplasty,TKA)术后髌骨高度的影响。方法:将86例骨性关节炎患者(116膝)分为A、B两组。A组为保留髌下脂肪垫组(59膝),B组为切除髌下脂肪垫组(57膝)。应用屈膝30°的侧位X线片,测量术前及术后随访时的Insall-Salvati比值以反映髌骨高度。结果:A组术前及术后随访时的Insall-Salvati比值差异无统计学意义(P>0.05),B组术前及术后随访时的Insall-Salvati比值差异有统计学意义(P<0.05)。结论:在TKA术中切除髌下脂肪垫会造成TKA术后髌骨高度下降,导致低位髌骨及髌腱短缩。

Objective ： To assess the effects of intrapatellar fat pad on the patellar height after TKA. Methods： 116 primary TKA （86 patients） of osteoarthritis were divided into two groups （A and B）. Group A （59 cases） was infrapatellar fat pad preserved. Group B（57 cases） was intrapatellar fat pad excised. The Insall-Salvati ratio was measured on preoperative and postoperative lateral ra- diographs which were taken with the knee in a position of 30~ flexion to reflect the patellar height. Results： The preoperative and postoperative patellar height showed no statistic significant difference in Group A （P 〉 0.05） and a significant change in Group B （P 〈0. 05）. Conclusion ： The excision of intrapatellar fat pad would cause the patellar height significantly decrease after TKA, leading to low patellar and patellar tendon shorting.