Kim Tae Kyun, Chung Byung June, Kang Yeon Gwi, Chang Chong Bum, Seong Sang Cheol
Joint Reconstruction Center, Seoul National University Bundang Hospital, 300 Gumidong, Bundangu, Seongnam-si, Gyunggido 463-707, South Korea.
Clin Orthop Relat Res. 2009 Apr;467(4):1007-14. doi: 10.1007/s11999-008-0557-0. Epub 2008 Oct 15.
Anthropometric patellar dimensions can influence implant design and surgical techniques in patellar resurfacing for TKA. We measured anthropometric patellar dimensions in 752 osteoarthritic knees (713 in females and 39 in males) treated with TKA in 466 Korean patients and compared them with reported dimensions for Western patients. We investigated the effects of postoperative overall thickness deviations, residual bony thickness after bone resection, and postoperative deviations of component center positions from median ridge positions versus clinical and radiographic outcomes evaluated 1 year after surgery. Korean patients undergoing TKA had thinner and smaller patellae than Western patients. We found no associations between preoperative to postoperative overall thickness differences and clinical and radiographic outcomes and no differences between knees with a residual bony thickness 12 mm or greater and knees with a residual thickness less than 12 mm, with the exception of WOMAC pain scores. We found no associations between postoperative deviations of component center position and clinical or radiographic outcomes. Our findings indicate bone resection for patellar resurfacing can be flexible without jeopardizing clinical outcome.
Level IV, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
人体测量学的髌骨尺寸会影响全膝关节置换术（TKA）中髌骨表面置换的植入物设计和手术技术。我们测量了466例韩国患者接受TKA治疗的752个骨关节炎膝关节（女性713例，男性39例）的人体测量学髌骨尺寸，并将其与西方患者报告的尺寸进行比较。我们研究了术后整体厚度偏差、骨切除术后残留骨厚度以及组件中心位置相对于术后1年评估的临床和影像学结果的中位数嵴位置的术后偏差的影响。接受TKA的韩国患者的髌骨比西方患者更薄更小。我们发现术前至术后整体厚度差异与临床和影像学结果之间没有关联，并且残留骨厚度≥12mm的膝关节与残留厚度＜12mm的膝关节之间没有差异，但WOMAC疼痛评分除外。我们发现组件中心位置的术后偏差与临床或影像学结果之间没有关联。我们的研究结果表明，髌骨表面置换的骨切除可以灵活进行而不危及临床结果。
IV级，预后研究。有关证据水平的完整描述，请参阅作者指南。
