Shon Oog-Jin, Kim Gi Beom
Department of Orthopedic Surgery, Yeungnam University College of Medicine, Yeungnam University Medical Center, Hyeonchungno 170, Nam-gu, Daegu, 42415, Republic of Korea.
Knee Surg Relat Res. 2022 Jul 18;34(1):36. doi: 10.1186/s43019-022-00161-3.
The aim of this study was to investigate whether the degree of patellar cartilage loss confirmed during index surgery affects the clinical and radiologic outcomes of total knee arthroplasty (TKA) performed without patellar resurfacing.
We prospectively divided 2012 patients with a minimum follow-up of 12 months into two groups according to intraoperatively graded cartilage lesions graded using the International Cartilage Repair Society (ICRS) system: group 1, grades 0‒2 (n = 110); group 2, grades 3‒4 (n = 102). Relevant locations, such as medial, lateral, or both facets of the patella, were also assessed. Clinical outcomes were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index, Feller's patella score, and Kujala anterior knee pain score. Radiographic outcomes included patellar tilt angle and lateral patellar shift on Merchant's view.
Clinical and radiographic outcomes were not significantly different between the two groups. No patient underwent secondary patellar resurfacing. Although the lateral facet was significantly more involved, there were no significant differences in outcomes.
The degree of intraoperatively identified patellar cartilage loss did not affect the short-term outcomes following primary TKA without patellar resurfacing. Level of evidence II: Prospective comparative study.
本研究旨在调查初次手术中确认的髌软骨损失程度是否会影响未进行髌骨表面置换的全膝关节置换术（TKA）的临床和放射学结果。
我们前瞻性地将2012例至少随访12个月的患者根据术中使用国际软骨修复协会（ICRS）系统分级的软骨损伤分为两组：第1组，0-2级（n = 110）；第2组，3-4级（n = 102）。还评估了髌骨的相关部位，如内侧、外侧或双侧小平面。使用西安大略和麦克马斯特大学骨关节炎指数、费勒髌骨评分和库亚拉膝前疼痛评分评估临床结果。放射学结果包括Merchant位片上的髌骨倾斜角和髌骨外侧移位。
两组的临床和放射学结果无显著差异。没有患者接受二次髌骨表面置换。虽然外侧小平面受累明显更多，但结果无显著差异。
术中确定的髌软骨损失程度不影响初次未进行髌骨表面置换的TKA术后的短期结果。证据级别II：前瞻性比较研究。
