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全膝关节置换术中髌骨高度的变化及其与髌骨是否置换的关系。

The Variation of the Patellar Height in Total Knee Arthroplasties and its Relationship with the Replacement or not of the Patella.

作者信息

Cenni Marcos Henrique Frauendorf, Pinheiro Junior Lúcio Flávio Biondi, Oliveira Mateus Aguilar de, Lago Augusto Groberio, Rodrigues Raphael Cardoso

机构信息

Rede Mater Dei de Saúde, Belo Horizonte, MG, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2021 Nov 1;58(1):67-71. doi: 10.1055/s-0041-1736468. eCollection 2023 Feb.

Abstract

To compare the measurement of patellar height in the pre- and postoperative period of total knee arthroplasties (TKAs) and its variation in patients with and without patellar replacement.  Retrospective evaluation of radiographs of patients submitted to TKA between 2014 and 2020. Profile radiographs were evaluated using the modified Caton-Deschamps patellar height index, comparing the pre- and postoperative measurements of 90 patients, with a total of 100 knees. Next, two groups were compared with a different surgical technique, considering the replacement or not of the patella. All patients who had x-rays evaluated had indication of TKA by osteoarthrosis without previous procedures that could interfere at patellar height.  The statistical analysis showed a statistically significant difference, with the preoperative index superior to the postoperative rate, evidencing an overall decrease in patellar height. The Caton-Deschamps index modified for mean preoperative TKA was 1.41 (±0.25), and it was 1.31 (± 0.25),  < 0.001for postoperative TKA. No significant difference was found in the variation of this index when comparing the groups with and without patellar replacement. The mean difference of the index in the group without patella was 0.11, and 0.08 in the group with patella, and this difference was considered nonsignificant,  = 0.510.  We can conclude that patellar height had significant variation in the total group, with reduction of patellar height in the postoperative period. However, the height did not vary significantly between the postoperative groups with and without patellar replacement, regardless of the choice of the surgeon.

摘要

比较全膝关节置换术(TKA)术前和术后的髌骨高度测量值,以及有无髌骨置换患者的髌骨高度变化。

对2014年至2020年间接受TKA的患者的X线片进行回顾性评估。使用改良的卡顿-德尚髌骨高度指数评估侧位X线片,比较90例患者(共100个膝关节)术前和术后的测量值。接下来,比较两组采用不同手术技术(即是否进行髌骨置换)的情况。所有接受X线评估的患者均因骨关节炎而有TKA指征,且之前没有可能影响髌骨高度的手术。

统计分析显示存在统计学显著差异,术前指数高于术后率,表明髌骨高度总体下降。术前TKA平均改良卡顿-德尚指数为1.41(±0.25),术后TKA为1.31(±0.25),P<0.001。比较有无髌骨置换的两组时,该指数的变化没有显著差异。无髌骨组指数的平均差异为0.11,有髌骨组为0.08,该差异被认为不显著,P = 0.510。

我们可以得出结论,整个组的髌骨高度有显著变化,术后髌骨高度降低。然而,无论外科医生的选择如何,有和无髌骨置换的术后组之间髌骨高度没有显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad87/10038717/79d9f6324cc0/10-1055-s-0041-1736468-i2100138en-1.jpg

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