髌骨置换与否对全膝关节置换术中患者膝关节功能的影响

Influence of patellar replacement on patients' knee function in total knee arthroplasty

目的探讨髌骨置换与否对全膝关节置换术中患者膝关节功能的影响。方法选取2012年1月至2013年1月我院收治的膝关节骨性关节炎患者80例(80膝),随机将其分为髌骨置换组和非髌骨置换组,每组40例。比较两组患者术后不同时间的KSS膝评分与功能评分、髌骨评分(PS)、疼痛视觉模拟评分(VAS)和影像学指标。结果与手术前比较,两组患者术后6周、术后3个月、术后6个月、术后1年的KSS膝评分、KSS功能评分、PS评分明显升高,VAS评分明显降低,差异均有统计学意义(P<0.05);与非髌骨置换组比较,髌骨置换组患者术后6个月、术后1年的KSS功能评分、PS评分较高,VAS评分较低,差异均有统计学意义(P<0.05)。两组患者术后1年的髌骨倾斜角、髌骨适合角、胫骨角、髌韧带比值比较差异均无统计学意义(P>0.05)。结论髌骨置换对全膝关节置换术中患者膝关节功能和髌骨功能的恢复具有改善作用,同时可以减少术后膝前痛的程度。

Objective To explore the influence of patellar replacement on patients＇ knee function in total knee arthroplasty. Methods Eighty knee osteoarthritis patients （80 knees） were selected from the hospital （time limited from January 2012 to January 2013）, and divided randomly into the patellar replacement group （Group PR） and non pa-tellar replacement group （Group NPR）, with 40 patients in each group. Patients＇ KSS knee and function score, patellar score （PS）, visual analog scale of pain （VAS） and imaging index in different period were recorded. Results After sur-gery, Patients＇ KSS knee score, KSS function score, PS in two groups were both increased at the postoperative 6 weeks, 3 months, 6 months and 12 months, while VAS decreased significantly. The differences were statistically signif-icant （P〈0.05）. Compared with Group NPR, the KSS function score and PS of patients in Group PR were increased at the postoperative 6 and 12 months, while VAS was decreased. The differences were statistically significant （P〈0.05）. There were no statistically significant differences between the two groups＇ patellar tilt angle, patellar congruence an-gle, tibial angle, and ratio of patellar ligament at the postoperative 12 months （P〉0.05）. Conclusion Total knee ar-throplasty with patellar replacement can improve both knee function and patella function, and meanwhile reduce post-operative anterior knee pain.