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翻修全膝关节置换术中的髌骨管理:髌骨表面置换术是更好的选择吗?

Patellar management in revision total knee arthroplasty: is patellar resurfacing a better option?

机构信息

Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California 94305, USA.

出版信息

J Arthroplasty. 2010 Jun;25(4):589-93. doi: 10.1016/j.arth.2009.04.009. Epub 2009 Jun 2.

Abstract

The management of the patella during revision total knee arthroplasty (TKA) depends on the indication for revision, the type and stability of the patellar component in place, and availability of bone stock. We prospectively compared the clinical outcome and satisfaction rates in revision TKA patients managed with patellar resurfacing (n = 13, group I) to retention of the patellar component (n = 22, group II) or patelloplasty (n = 11, group III) at a minimum follow-up of 2 years. There were no differences in the improvement of Knee Society Scores, Short-Form 36 Scores, and satisfaction rates between the groups. There were no revision surgeries for patellar component failure or patellar fractures. Satisfactory results can be achieved using a variety of methods of patellar management in revision TKA by individualizing the treatment modality depending on the clinical scenario.

摘要

在翻修全膝关节置换术(TKA)中,髌骨的处理取决于翻修的适应证、在位髌骨组件的类型和稳定性以及骨质的可用性。我们前瞻性比较了髌骨表面置换(n=13,I 组)、保留髌骨组件(n=22,II 组)或髌骨成形术(n=11,III 组)治疗翻修 TKA 患者的临床结果和满意度,随访时间至少为 2 年。三组间膝关节协会评分、36 项简短健康调查问卷评分和满意度的改善均无差异。没有因髌骨组件失效或髌骨骨折而进行翻修手术。根据临床情况个体化治疗方式,在翻修 TKA 中可采用多种髌骨处理方法,获得满意的结果。

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