髁下截骨和假性髁下截骨不能改善 Mega-TKA 后患者的关节活动度。
Reduction of Patella-baja and Pseudo-patella-baja Does Not Improve Range of Motion in Patients After Mega-TKA.
机构信息
Trauma Department, Hannover Medical School, Hannover, Germany
Trauma Department, Hannover Medical School, Hannover, Germany.
出版信息
In Vivo. 2020 May-Jun;34(3):1153-1158. doi: 10.21873/invivo.11887.
BACKGROUND/AIM: Patella baja (PB) and pseudo-patella baja (PPB) have been shown to negatively influence outcomes after total knee arthroplasty. We hypothesized that there is a high incidence of PB and PPB after megaprosthetic total knee arthroplasty (M-TKA), and that this is associated with reduced range of motion.
PATIENTS AND METHODS
We retrospectively analysed all patients in our Orthopaedic Trauma Department after distal femur or proximal tibia replacement. Preoperative and one-year postoperative follow-up included measurement of range of motion and detection of PB and PPB using radiological indices.
RESULTS
We included 44 patients (age: 73±19 years). Preoperative PB detected by ISI could be reduced from 13 (36%) to 11 (25%) (p<0.01). Preoperative vs. postoperative ISI was 0.88±0.23 vs. 1.06±0.45 (p=0.03). PPB was observed preoperatively in 23 (63%) patients vs. 24 (54%) postoperatively. Preoperative vs. postoperative CDI was 0.70±0.24 vs. 0.95±0.43 (p=0.002). Preoperative flexion was 91°±30° vs. 85°±24° postoperatively (p>0.05).
CONCLUSION
Both PB and PPB are frequently observed after M-TKA. A reduction in PB and PPB alone does not improve postoperative range of motion.
背景/目的：髌下极（PB）和假性髌下极（PPB）已被证明会对全膝关节置换术后的结果产生负面影响。我们假设在巨大假体全膝关节置换术（M-TKA）后存在较高的 PB 和 PPB 发生率，并且这与活动范围减小有关。
患者和方法
我们回顾性分析了我们矫形创伤科所有接受股骨远端或胫骨近端置换的患者。术前和术后一年的随访包括测量活动范围以及使用影像学指标检测 PB 和 PPB。
结果
我们纳入了 44 名患者（年龄：73±19 岁）。ISI 检测到的术前 PB 可从 13（36%）减少到 11（25%）（p<0.01）。术前与术后 ISI 分别为 0.88±0.23 和 1.06±0.45（p=0.03）。术前 23 例（63%）患者存在 PPB，术后为 24 例（54%）。术前与术后 CDI 分别为 0.70±0.24 和 0.95±0.43（p=0.002）。术前屈曲度为 91°±30°，术后为 85°±24°（p>0.05）。
结论
M-TKA 后常观察到 PB 和 PPB。单独降低 PB 和 PPB 并不能改善术后活动范围。
Zotero 插件