髌下脂肪垫对全膝关节置换术后关节功能的影响

The Influence of Fat Pad on Joint Function After Total Knee Arthroplasty Patella

目的探讨髌下脂肪垫对全膝关节置换术后关节功能的影响。方法453例初次行全膝关节置换术患者,根据术中是否保留脂肪垫分为脂肪垫保留组217例(267膝)与脂肪垫切除组236例(293膝),术前、术后6、12个月采用WOMAC疼痛量表评价关节疼痛程度,膝评分和功能评分采用美国膝关节协会评分系统(AKS)行膝评分与功能评分。结果术前两组WOMAC骨关节疼痛指数差异无统计学意义(P>0.05),术后6、12个月,两组WOMAC骨关节疼痛指数均较术前降低,且脂肪垫保留组低于脂肪垫切除组,组内与组间差异均有统计学意义(P<0.05);两组术前AKS膝评分与功能评分差异无统计学意义(P>0.05),术后6、12个月,两组AKS膝评分与功能评分均较术前提高,差异有统计学意义(P<0.05),但两组术后6、12个月组间评分差异无统计学意义(P>0.05)。结论髌下脂肪垫对全膝关节置换后有关关节功能评价的指标无明显影响,但可引起术后疼痛,是否切除需慎重考虑。

Objective To explore the effect of infrapatellar fat pad on the functional recovery of joint in patients following total knee arthroplasty. Methods 453 cases of patients undergoing totalknee arthroplasty were divided into fat pad preservation group of 217 cases（267 knees） and fat pad excision group of 236 cases（293 knees） according to fat pad being resected or not. The degree of joint pain was evaluated by the WOMAC pain scale and knee grade and function by the American association of knee scoring system（AKS） line knee scores and function score preoperative and postoperative 6 and 12 months. Results The WOMAC pain scale index before operation between the two groups had no statistical significance（P 0.05）, 6 and 12 months after operation the WOMAC pain scale index of the two groups were reduced, and the differences between groups and in the group had statistical significance（P 0.05）. AKS knee score and function score between the two groups had no statistical significance（P 0.05）, 6 and 12 months after operation, AKS knee score and function score of the two group were enhanced, and the difference was statistically significant（P 0.05）.But there was no significant difference between the 6 groups in two and 12 months after operation（P 0.05）. Conclusion Infrapatellar fat pad has no obvious effect on the evaluation index of oint function after total knee replacement, but can cause postoperative pain. It should be careful consideration whether resection should be considered whether to remove infrapatellar fat pad.