髌骨合理设计在全膝关节置换中的临床效果

Clinical effect of suitable patellar design in total knee arthroplasty

目的探讨髌骨合理设计后重塑在全膝关节置换（TKA）中的临床效果。方法根据股骨假体滑动轨迹及所需置换髌骨的形态,对56例TKA患者（72膝）术中进行髌骨合理设计并重塑,观察患者术后的关节活动度及疼痛情况,用KSS膝关节评分系统评定治疗效果。结果 56例均获得随访,时间6~18个月。仅1例患者膝关节活动度70°,活动较差,但疼痛明显减轻;其余患者屈曲活动度在0°~110°。KSS评分：优69膝,良2膝,中1膝,优良率达到98.6%。结论术中根据股骨假体滑动轨迹对髌骨合理设计并重塑,可以使未进行髌骨置换的TKA患者取得满意的治疗效果。

Objective To investigate the clinical effect of suitable patellar design in total knee arthroplasty（ TKA）.Methods Total 56 cases（ 72 knees） were received TKA with the patellar movement design based on the shape and the movement track of patellar,the range of motion and the feeling of pain of knee joint was observed. The Knee Society Rating System score（ KSS） was used to evaluate the TKA surgery effect. Results All 56 cases obtained followup time of ranging from 6 months to 18 months. Only one patient had the worse range of flexion motion within 70°,but the pain was reduced obviously; the other patients had improved the flexion and extension function and reduced the pain postoperatively. The range of flexion motion was within 0° ~ 110°,The KSS socres showed that 69 knees were excellent,2 knees good,1 fair,the excellent-good rate reached 98. 6%. Conclusions It can obtain satisfied therapeutic effect by rebuilding the patellar movement based on the femur prosthesis track rather than doing patellar surface replacement during the TKA surgery.