Han I, Chang C B, Lee S, Lee M C, Seong S C, Kim T K
Joint Reconstruction Centre, Seoul National University Bundang Hospital, 300 Gumidong, Seongnamsi, Gyunggido, Korea.
J Bone Joint Surg Br. 2005 Aug;87(8):1081-4. doi: 10.1302/0301-620X.87B8.16209.
We sought to determine the degree of correlation between the condition of the patellar articular cartilage and patellofemoral symptoms and function in osteoarthritic patients undergoing total knee arthroplasty. The depth of the osteoarthritic lesion, as graded by the Outerbridge classification and its size and location were assessed to determine the condition of the patellar cartilage in 80 consecutive osteoarthritic knees undergoing total knee arthroplasty. The association between the condition of the cartilage and patellofemoral symptoms and function was investigated by correlation analysis. The depth and size of the lesion had a significant but weak correlation with anterior knee pain (r = -0.300 and -0.289; p = 0.007 and 0.009, respectively), whereas location had no significant association (p > 0.05). None had a significant association with patellofemoral functional parameters (chair-rising, stair-climbing, and quadriceps power) (p > 0.05). Our study indicates that patellofemoral symptoms and function are not completely determined by the condition of the cartilage. Caution should be taken when the symptoms and functional limitations are attributed to a lesion in the patellofemoral joint in making a decision regarding patellar resurfacing in total knee arthroplasty.
我们试图确定在接受全膝关节置换术的骨关节炎患者中，髌骨关节软骨状况与髌股症状及功能之间的相关程度。对连续80例接受全膝关节置换术的骨关节炎膝关节，通过评估按Outerbridge分级的骨关节炎病变深度及其大小和位置，来确定髌软骨的状况。通过相关性分析研究软骨状况与髌股症状及功能之间的关联。病变的深度和大小与膝前疼痛存在显著但较弱的相关性（r分别为-0.300和-0.289；p分别为0.007和0.009），而位置无显著关联（p>0.05）。均与髌股功能参数（从椅子起身、爬楼梯和股四头肌力量）无显著关联（p>0.05）。我们的研究表明，髌股症状和功能并非完全由软骨状况决定。在全膝关节置换术中决定是否进行髌骨表面置换时，当将症状和功能受限归因于髌股关节病变时应谨慎。
