Zhao Gang, Liu Yujie, Yuan Bangtuo, Shen Xuezhen, Qu Feng, Wang Jiangtao, Qi Wei, Zhu Juanli, Liu Yang
Department of Orthopedics, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Chin Med J (Engl). 2015 Jan 5;128(1):79-84. doi: 10.4103/0366-6999.147820.
Patellofemoral osteoarthritis commonly occurs in older people, often resulting in anterior knee pain and severely reduced quality of life. The aim was to examine the effectiveness of arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis (PFOA).
A total of 156 PFOA patients (62 males, 94 females; ages 45-81 years, mean 66 years) treated in our department between September 2012 and March 2013 were involved in this study. Clinical manifestations included recurrent swelling and pain in the knee joint and aggravated pain upon ascending/descending stairs, squatting down, or standing up. PFOA was treated with arthroscopic patelloplasty and circumpatellar denervation. The therapeutic effects before and after surgery were statistically evaluated using Lysholm and Kujala scores. The therapeutic effects were graded by classification of the degree of cartilage defect.
A total of 149 cases were successfully followed up for 14.8 months, on average. The incisions healed well, and no complications occurred. After surgery, the average Lysholm score improved from 73.29 to 80.93, and the average Kujala score improved from 68.34 to 76.48. This procedure was highly effective for patients with cartilage defects I-III but not for patients with cartilage defect IV.
For PFOA patients, this procedure is effective for significantly relieving anterior knee pain, improving knee joint function and quality of life, and deferring arthritic progression.
髌股关节炎常见于老年人,常导致膝关节前部疼痛并严重降低生活质量。目的是研究关节镜下髌骨成形术和髌骨周围去神经术治疗髌股关节炎(PFOA)的有效性。
本研究纳入了2012年9月至2013年3月在我科治疗的156例PFOA患者(男性62例,女性94例;年龄45 - 81岁,平均66岁)。临床表现包括膝关节反复肿胀和疼痛,上下楼梯、下蹲或站立时疼痛加重。采用关节镜下髌骨成形术和髌骨周围去神经术治疗PFOA。使用Lysholm和Kujala评分对手术前后的治疗效果进行统计学评估。根据软骨缺损程度分类对治疗效果进行分级。
共149例患者成功随访,平均随访14.8个月。切口愈合良好,未发生并发症。术后,Lysholm评分平均从73.29提高到80.93,Kujala评分平均从68.34提高到76.48。该手术对Ⅰ - Ⅲ级软骨缺损患者疗效显著,但对Ⅳ级软骨缺损患者无效。
对于PFOA患者,该手术可有效显著缓解膝关节前部疼痛,改善膝关节功能和生活质量,并延缓关节炎进展。