初次全膝关节置换是否髌骨表面置换的比较

Primary total knee arthroplasty with or without patellar resurfacing

摘要:

[目的]比较初次人工全膝关节置换术（total knee arthroplasty, TKA）是否髌骨置换的早期临床疗效。[方法]回顾分析 2018 年 2 月—2020 年 12 月本科室收治的 45 例 （52 膝） 初次 TKA 治疗晚期骨关节炎患者的临床资料，根据医患沟通结果，24 例 （28 膝） 行髌骨置换，21 例 （24 膝） 未行髌骨置换。比较两组围手术期与随访结果。[结果] 两组患者均顺利完成手术，两组手术时间、术中出血量、切口长度和术后下地时间的差异均无统计学意义 （P＞0.05）。两组患者均获得 3 个月以上随访，与术前相比，末次随访时两组患者的 VAS 和 KSS 评分均显著改善，末次随访时，两组间 VAS 评分 [(1.6±1.0) vs (1.8± 0.9), P=0.781]、KSS 评分 [(86.3±7.9) vs (84.6±7.9), P=0.865] 的差异均无统计学意义 （P＞0.05）。[结论] 初次 TKA 术是否行髌骨置换的早期疗效无明显差异。

Abstract:

[Objective] To compare the early clinical outcomes of primary total knee arthroplasty (TKA) with or without patellar resurfacing. [Methods] A retrospective study was conducted on of 45 patients (52 knees) who received primary TKA for knee osteoarthritis in our departments from February 2018 to December 2020. According to doctor-patient discussion, 24 patients (28 knees) had patellar resurfacing replacement, while other 21 patients (24 knees) had not patellar resurfacing replacement in TKA. The perioperative and follow-up results were compared between the two groups. [Results] The operation was successfully completed in both groups, and there were no significant differences in operation time, intraoperative blood loss, incision length and postoperative ambulation between the two groups (P＞0.05). All patients in both groups were followed up for more than 3 months, and got significant improvement in terms of VAS and KSS scores at the last followup compared with those before surgery. However, there were no significant differences between the two groups in VAS score [(1.6±1.0) vs (1.8±0.9), P=0.781] and KSS score [(86.3±7.9) vs (84.6±7.9), P=0.865] at the latest follow-up. [Conclusion] There is no significant difference in term of the early consequence of primary TKA with or without patellar resurfacing replacement.