Liu Zhong-tang, Wu Yu-li, Li Xiao-hua, Qian Qi-rong, Zhu Yun-li, Wu Hai-shan
Department of Orthopedics, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China.
Zhonghua Wai Ke Za Zhi. 2007 Aug 15;45(16):1087-90.
To investigate the differences in the clinical outcome of total knee arthroplasty according to patellar reshaping or resurfacing.
From January 2002 to December 2002, 60 patients (60 knees) undergoing primary total knee arthroplasty for the treatment of osteoarthritis were enrolled in a prospective, randomized study. All patients received the same posterior-cruciate-substituting total knee prosthetic components. Patients were randomized to the treatment with reshaping or resurfacing of the patella, and the results were followed up for a mean of 54 months (40-60 months). Evaluations consisted of the determination of a Knee Society Score, range of motion for knees, patient satisfaction, and radiographs.
With the numbers available for study, no significant difference was found between the knees that had patellar resurfacing and those that had patellar reshaping with regard to the overall score (P=0.12), the subscore for pain (P=0.90), and patient satisfaction (P=0.22). The results showed that the same prevalence of any anterior knee pain in two groups was 10%, and it did not represent a significant difference. The two groups showed statistical difference with regard to the total function score and range of motion.
It has shown that total knee arthroplasty with patella reshaping or resurfacing dramatically relieves pain and improves the function. It seems that postoperative anterior knee pain is related either to the component design or to the details of the surgical technique, rather than to whether or not the patella is resurfaced.
根据髌骨重塑或表面置换情况，研究全膝关节置换术临床结果的差异。
2002年1月至2002年12月，60例因骨关节炎接受初次全膝关节置换术的患者（60膝）纳入一项前瞻性随机研究。所有患者均接受相同的后交叉韧带替代型全膝关节假体组件。患者被随机分为髌骨重塑或表面置换治疗组，平均随访54个月（40 - 60个月）。评估包括膝关节协会评分测定、膝关节活动范围、患者满意度及X线片。
就研究可得数据而言，髌骨表面置换组与髌骨重塑组在总体评分（P = 0.12）、疼痛子评分（P = 0.90）及患者满意度（P = 0.22）方面未发现显著差异。结果显示两组前膝疼痛发生率均为10%，无显著差异。两组在总功能评分及活动范围方面存在统计学差异。
结果表明，髌骨重塑或表面置换的全膝关节置换术能显著缓解疼痛并改善功能。术后前膝疼痛似乎与假体组件设计或手术技术细节有关，而非与髌骨是否进行表面置换有关。
