Abd-el Wahab M, Szepesi K, Szücs G, Farkas C, Csernátony Z
Department of Orthopaedics, University Medical School, Debrecen, Hungary.
Acta Chir Hung. 1998;37(1-2):59-66.
There has been no universal agreement so far regarding the necessity of patellar resurfacing in total knee arthroplasty. As resurfacing has been reported to be associated with high incidence of complications, this practice has been avoided in our Department. A report is given on the analysis of the functional outcome of 60 knee arthroplasties without patellar resurfacing in 53 patients (7 bilateral) followed up for twelve to thirty months, with special regard to the functions closely related to patelloformal articulation. The underlying diagnosis was osteoarthritis in 78.3%, rheumatoid arthritis in 13.3%, and posttraumatic arthritis in 8.3% of the patients. Graded according to the modified knee-rating system of the Hospital for Special Surgery, excellent or good results were obtained in the case of 55 knees (91.6%) and the mean score improved from 53.6 points preoperatively to 82.6 points following arthroplasty. Subjective and objective functional assessment of stair climbing and transfer activities have shown no functional deficit attributed to the patellofemoral joint of the replaced knee.
迄今为止,对于全膝关节置换术中髌骨表面置换的必要性尚未达成普遍共识。由于据报道表面置换与高并发症发生率相关,我们科室避免了这种做法。本文报告了对53例患者(7例双侧)共60例未进行髌骨表面置换的膝关节置换术患者进行随访12至30个月的功能结果分析,特别关注与髌股关节相关的功能。患者的基础诊断为骨关节炎占78.3%,类风湿性关节炎占13.3%,创伤后关节炎占8.3%。根据特殊外科医院改良的膝关节评分系统进行分级,55个膝关节(91.6%)获得了优秀或良好的结果,平均评分从术前的53.6分提高到置换术后的82.6分。对上下楼梯和转移活动的主观和客观功能评估显示,置换膝关节的髌股关节没有功能缺陷。