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保留髌骨的全膝关节置换术中髌骨去骨赘与髌骨外侧关节面切除术的比较

Osteophytes removal in patella versus lateral facetectomy of the patella in patella-retaining total knee arthroplasty.

作者信息

Moghtadaei Mehdi, Sajadi Mohammad Reza Miniator, Farahini Hossein, Yeganeh Ali

机构信息

Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Science, Tehran, Iran and Department of Orthopedics, Rasoul-e-akram Hospital, Iran University of Medical Science, Tehran, Iran.

出版信息

Interv Med Appl Sci. 2017 Mar;9(1):15-19. doi: 10.1556/1646.9.2017.1.07.

Abstract

BACKGROUND

In this study, the results of the partial lateral facetectomy of the patella to better patellofemoral motion and congruence are compared with the results of the osteophyte removal of the patella and neurectomy only in total knee arthroplasty (TKA).

METHODS

Data from 55 patients undergoing TKA with osteophytes removal of the patella and neurectomy only, and those undergoing osteophytes removal of the patella and neurectomy and partial lateral facetectomy were reviewed retrospectively. Clinical outcomes were evaluated by knee society score (KSS) and functional score of knee. Clinical anterior knee pain (AKP) rating and knee range of motion and extension lag were assessed for each patient.

RESULTS

There was significant difference between two groups in AKP ( < 0.05), and the mean range of motion of the knee in groups 1 and 2 was 117° ± 9° and 116.6° ± 8.2°, respectively. Three (13%) patients of the reshaped patella group and three (11%) patients of the non-reshaped patella group had extension lag <10°, respectively. The mean KSS and knee functional scores showed no statistical difference between groups ( > 0.05).

CONCLUSION

Partial lateral facetectomy of the patella can decrease AKP and can be used routinely for every patient that surgeon does not decide to resurface the patella.

摘要

背景

在本研究中,仅在全膝关节置换术(TKA)中,将髌骨部分外侧关节面切除术改善髌股关节运动和匹配度的结果与髌骨骨赘切除术及神经切除术的结果进行比较。

方法

回顾性分析55例仅接受髌骨骨赘切除术及神经切除术的TKA患者,以及接受髌骨骨赘切除术、神经切除术和部分外侧关节面切除术患者的数据。通过膝关节协会评分(KSS)和膝关节功能评分评估临床结果。对每位患者评估临床前膝痛(AKP)评分、膝关节活动范围和伸直滞后情况。

结果

两组在AKP方面存在显著差异(<0.05),第1组和第2组膝关节的平均活动范围分别为117°±9°和116.6°±8.2°。重塑髌骨组和未重塑髌骨组分别有3例(13%)和3例(11%)患者伸直滞后<10°。两组的平均KSS和膝关节功能评分无统计学差异(>0.05)。

结论

髌骨部分外侧关节面切除术可降低AKP,对于外科医生不决定对髌骨进行表面置换的每位患者可常规使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2155/5598117/08c14ebb1e8c/imas-09-01-15_f001.jpg

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