全膝关节置换术联合胫骨结节截骨内移治疗膝关节炎合并髌骨完全脱位

The total knee arthroplasty combined with medial displacement of tibial tubercle osteotomy for knee osteoarthritis with complete dislocation of patella

目的探讨全膝关节置换术(TKA)联合胫骨结节截骨内移治疗膝关节炎合并髌骨完全脱位的疗效。方法采用TKA联合胫骨结节截骨内移治疗10例膝关节炎合并髌骨完全脱位患者。记录术后并发症、髌骨位置以及末次随访时临床疗效。结果切口均一期愈合。患者均获得随访,时间1~4年。术后摄X线片复查显示假体位置良好,髌骨完全复位。随访期间,无一例髌骨复发脱位,无假体周围骨溶解和松动。膝关节KSS临床评分、KSS功能评分、机械轴膝外翻、膝关节活动度末次随访时与术前比较差异均有统计学意义(P<0.05)。结论TKA联合胫骨结节截骨内移治疗膝关节炎合并髌骨完全脱位,疗效满意,并发症较少。

Objective To investigate the effect of medial displacement of total knee arthroplasty(TKA)combined with medial displacement of tibial tubercle osteotomy(TTO)for knee osteoarthritis with complete dislocation of patella.Methods The 10 patients with knee osteoarthritis and complete dislocation of patella were performed with TKA combined with medial displacement of TTO.The postoperative complication,patellar position,postoperative complications and clinical efficacy of last follow-up were recorded.Results All patients′incisions got primary healing.All patients were followed up for 1~4 years.The postoperative X-ray film reexamination showed that the prosthesis was in good position,and the patella was completely restored.During the follow-up period,there was no recurrent dislocation of the patella,no osteolysis or loosening around the prosthesis.The KSS clinical score,KSS function score,mechanical axis knee valgus,and knee range of motion at the last follow-up were significantly different from those before surgery(P<0.05).Conclusions The TKA combined with medial displacement of TTO for knee osteoarthritis with complete dislocation of patella can achieve satisfactory results,with few complications.