Feng Bin, Ren Yi, Lin Jin, Jin Jin, Qian Wenwei, Weng Xisheng
Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China.
Medicine (Baltimore). 2020 Mar;99(11):e19080. doi: 10.1097/MD.0000000000019080.
The study aims to evaluate the clinical outcomes and surgery survivorship for over 10 years following patellar resurfacing or nonresurfacing in total knee arthroplasty (TKA) in a cohort of Chinese patients.From 1998 to 2003, 355 patients underwent primary TKA in our institute. The survivorship of TKA between the patellar resurfacing and nonresurfacing groups and the clinical outcome of Hospital for Special Surgery knee score, Western Ontario and McMaster Universities index score, patellar score, patellar related complications, and radiological results were studied at latest follow-up.There was no statistically significant difference for the Hospital for Special Surgery score, Western Ontario and McMaster Universities score, and the patellar score between the 2 groups after an average 12.4-year follow-up. Nonresurfacing group had higher anterior knee pain than the resurfacing group (13.2% vs 5.6%). The patients with rheumatoid arthritis had a 2.9-fold higher rate of patellar-related complications than did the patients with osteoarthritis. The 10-year survival rate was not significantly different between the 2 groups both for revision surgery (P = .505) and for patellar-related complication (P = .194).There was no significant difference in the long-term clinical outcome and survivorship between patellar resurfacing and nonresurfacing. Patellar nonresurfacing could be advisable during primary TKA for osteoarthritis patients. Selective patellar resurfacing for RA patients could achieve lower patellar-related complications.
本研究旨在评估中国患者行全膝关节置换术(TKA)时髌骨表面置换或不置换术后10年以上的临床结局和手术生存率。1998年至2003年,我院355例患者接受了初次TKA。在最近一次随访时,研究了髌骨表面置换组和未置换组TKA的生存率,以及特种外科医院膝关节评分、西安大略和麦克马斯特大学指数评分、髌骨评分、髌骨相关并发症和影像学结果的临床结局。平均随访12.4年后,两组在特种外科医院评分、西安大略和麦克马斯特大学评分以及髌骨评分方面无统计学显著差异。未置换组的膝前疼痛高于置换组(13.2%对5.6%)。类风湿关节炎患者的髌骨相关并发症发生率比骨关节炎患者高2.9倍。两组在翻修手术(P = 0.505)和髌骨相关并发症(P = 0.194)方面的10年生存率无显著差异。髌骨表面置换和不置换在长期临床结局和生存率方面无显著差异。对于骨关节炎患者,初次TKA时可不进行髌骨表面置换。对类风湿关节炎患者进行选择性髌骨表面置换可降低髌骨相关并发症。