Muoneke H E, Khan A M, Giannikas K A, Hägglund E, Dunningham T H
Orthopaedic Department, Tameside General Hospital, Ashton-under-Lyne, England, UK.
J Bone Joint Surg Br. 2003 Jul;85(5):675-8.
Out of a total of 623 patients who, over a ten-year period, underwent primary total knee replacement (TKR) without patellar resurfacing, 20 underwent secondary resurfacing for chronic anterior knee pain. They were evaluated pre- and postoperatively using the clinical and radiological American Knee Society score. The mean follow-up was 36.1 months (12 to 104). The mean knee score improved from 46.7 to 62.2 points and the mean functional score from 44.7 to 52.2 points. Only 44.4% of the patients, however, reported some improvement; the remainder reported no change or deterioration. The radiographic alignment of the TKR did not influence the outcome of secondary resurfacing of the patella. Complications were noted in six of the 20 patients including fracture and instability of the patella and loss of movement. Anterior knee pain after TKR remains difficult to manage. Secondary resurfacing of the patella is not advocated in all patients since it may increase patient dissatisfaction and hasten revision.
在总共623例患者中，他们在十年期间接受了未进行髌骨表面置换的初次全膝关节置换术（TKR），其中20例因慢性膝前疼痛接受了二次表面置换。使用美国膝关节协会临床和放射学评分对他们进行术前和术后评估。平均随访时间为36.1个月（12至104个月）。膝关节平均评分从46.7分提高到62.2分，功能平均评分从44.7分提高到52.2分。然而，只有44.4%的患者报告有一些改善；其余患者报告无变化或病情恶化。TKR的影像学对线情况并未影响髌骨二次表面置换的结果。20例患者中有6例出现并发症，包括髌骨骨折、不稳定和活动度丧失。TKR后的膝前疼痛仍然难以处理。不提倡对所有患者进行髌骨二次表面置换，因为这可能会增加患者的不满并加速翻修。
