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初次全膝关节置换术后持续性前膝痛的二期髌骨表面置换术。

Patellar resurfacing as a second stage procedure for persistent anterior knee pain after primary total knee arthroplasty.

机构信息

Orthopaedic and Tumour Orthopaedic, University Hospital Münster, Münster, Germany.

出版信息

Int Orthop. 2012 Jun;36(6):1181-3. doi: 10.1007/s00264-011-1463-8. Epub 2012 Jan 14.

Abstract

PURPOSE

Knee pain after total knee arthroplasty may be caused by an unresurfaced patella. Secondary isolated resurfacing of the previously unresurfaced patella in total knee arthroplasty remains controversial. The aim of this retrospective study was to evaluate the outcome after patellar resurfacing as a second stage procedure.

METHODS

The study included 22 patients (13 female/nine male) who underwent resurfacing of the patella with a mean follow-up of 61.8 ± 39.2 months. The mean age of the patients was 60 ± 9.7 years at the time of operation. The average period between total knee arthroplasty and patellar resurfacing was 26.3 ± 15.2 months. The patient's subjective satisfaction was assessed by a custom-made questionnaire.

RESULTS

The mean Knee Society Score improved significantly from 60.1 ± 8.3 to 77.0 ± 6.3 (p = 0.0063). The mean functional score also improved significantly from 42.7 ± 2.3 to 60.2 ± 3.9 (p = 0.001). Three patients (13.6%) needed further operative revision.

CONCLUSIONS

Although clinical scores showed significant improvement some patients continued to have pain and remained dissatisfied without detecting a specific reason. Further studies are needed to better elucidate the benefit of patellar resurfacing as second stage procedure.

摘要

目的

全膝关节置换术后的膝关节疼痛可能是由于髌骨未被覆盖引起的。在全膝关节置换术中,对先前未被覆盖的髌骨进行二次单独覆盖仍然存在争议。本回顾性研究的目的是评估作为二期手术进行髌骨覆盖的结果。

方法

本研究纳入了 22 名患者(13 名女性/9 名男性),平均随访 61.8±39.2 个月。患者的平均年龄为 60±9.7 岁,在手术时。全膝关节置换术和髌骨覆盖术之间的平均时间间隔为 26.3±15.2 个月。通过定制的问卷评估患者的主观满意度。

结果

膝关节协会评分从 60.1±8.3 显著提高至 77.0±6.3(p=0.0063)。平均功能评分也从 42.7±2.3 显著提高至 60.2±3.9(p=0.001)。3 名患者(13.6%)需要进一步手术修正。

结论

尽管临床评分显示出显著改善,但一些患者仍持续存在疼痛且不满意,而没有发现特定的原因。需要进一步的研究来更好地阐明作为二期手术进行髌骨覆盖的益处。

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