Holt Ginger E, Dennis Douglas A
Department of Orthopaedic Surgery Vanderbilt University Medical Center Nashville, Tennessee, USA.
Clin Orthop Relat Res. 2003 Nov(416):76-83. doi: 10.1097/01.blo.0000092991.90435.fb.
The ideal treatment of the patella in primary total knee arthroplasty (TKA) for osteoarthritis (OA) remains unclear. Although data exist in the literature to support either resurfacing or not resurfacing the patella, evidence continues to emerge that unresurfaced patellas deteriorate with time. Recent prospective, randomized studies also favor patellar resurfacing over retaining the native patella, reporting reoperation rates to convert unresurfaced to resurfaced patellas exceeding those for complications after patellar resurfacing. In addition, the incidence of residual patellofemoral pain after secondary resurfacing is substantially higher than when patellofemoral resurfacing is done primarily. Patient selection criteria are critical in the decision-making process. Patellofemoral complications, the greatest argument against resurfacing, have been diminished with improved surgical techniques and implant design.
在原发性全膝关节置换术（TKA）治疗骨关节炎（OA）中，髌骨的理想治疗方法仍不明确。尽管文献中有数据支持对髌骨进行表面置换或不进行表面置换，但越来越多的证据表明，未进行表面置换的髌骨会随着时间推移而退变。最近的前瞻性随机研究也倾向于髌骨表面置换而非保留天然髌骨，报道将未进行表面置换的髌骨转换为表面置换的再次手术率超过了髌骨表面置换后的并发症发生率。此外，二次表面置换后残留髌股关节疼痛的发生率明显高于初次进行髌股关节表面置换时。患者选择标准在决策过程中至关重要。髌股关节并发症是反对表面置换的最主要理由，但随着手术技术和植入物设计的改进，其发生率已有所降低。
