Department of Orthopedic Surgery, Korean Armed Forces Yangju Hospital, Yangju, Korea.
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Clin Orthop Surg. 2024 Apr;16(2):242-250. doi: 10.4055/cios22253. Epub 2023 Sep 7.
During total knee arthroplasty (TKA), patellar retention is performed when the cartilage is fairly well preserved and the thickness of the patella is relatively thin. However, clinical outcomes of the non-resurfaced patella in TKA according to the cartilage status are lacking in the literature. The purpose of this study was to compare patient-reported outcome measures (PROMs) according to the grade and location of the patellar cartilage lesion in TKA patients.
The outcomes of 165 osteoarthritis patients (186 knees) who underwent cemented mobile-bearing TKA without patellar resurfacing were assessed and classified according to the grade and location of the patellar cartilage lesion. PROMs using the Western Ontario and MacMaster Universities Osteoarthritis index, the Knee Society Score (Knee Society Function Score and Knee Society Knee Score), and the Hospital for Special Surgery score were evaluated preoperatively and at postoperative 2, 4, 6, and 8 years. The correlations between PROMs and the grade and location of the cartilage lesion were assessed. Additionally, radiologic outcomes including the patellar tilt angle and patellar height were assessed and their correlation with the grade of cartilage lesion was analyzed. Analysis of variance was used to determine statistical significance.
There was no significant difference between PROMs according to the grades and locations of cartilage lesions at any postoperative follow-up. Radiologic parameters also showed no significant differences according to the grades of patellar cartilage lesions.
The grade and location of the patellar cartilage lesion had no influence on clinical outcomes in mobile-bearing TKA with patellar retention at short- and long-term follow-up.
在全膝关节置换术(TKA)中,当软骨保存良好且髌骨较薄时,可选择保留髌骨。然而,关于 TKA 中非髌骨表面化患者的临床结果,文献中缺乏相关内容。本研究的目的是根据髌骨软骨病变的程度和位置比较 TKA 患者的患者报告的结局测量指标(PROMs)。
评估了 165 例接受无髌骨表面化水泥固定活动平台 TKA 的骨关节炎患者(186 膝)的结果,并根据髌骨软骨病变的程度和位置进行分类。使用 Western Ontario 和麦克马斯特大学骨关节炎指数、膝关节协会评分(膝关节协会功能评分和膝关节协会膝关节评分)和特殊外科医院评分评估术前以及术后 2、4、6 和 8 年的 PROMs。评估 PROMs 与软骨病变的程度和位置之间的相关性。此外,评估包括髌骨倾斜角和髌骨高度在内的放射学结果,并分析其与软骨病变程度的相关性。采用方差分析确定统计学意义。
在任何术后随访中,根据软骨病变的程度和位置,PROMs 之间均无显著差异。放射学参数也根据髌骨软骨病变的程度没有显著差异。
在短期和长期随访中,保留髌骨的活动平台 TKA 中,髌骨软骨病变的程度和位置对临床结果没有影响。